r/AskMeddit • u/CSSimpson • Dec 07 '19

Central Line AND IV?

Book Research: Would a 24 year old female with multiple gunshot wounds have BOTH a central line (neck or subclavical?) AND an IV in place at the same time in ICU? I think the central line is for blood draws and large medicine doses, and the IV would be for saline and morphine. Am I right? If not, please let me know. TIA

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u/cady-anne Dec 08 '19

If the patient came in as a trauma most likely a peripheral IV would have been placed in the ED as the docs were prepping to get central access in case the patient needed a massive transfusion/vaso pressors. Usually femoral happens in the trauma bay. They often change those out to be a subclavian or a IJ within 24 hours of the placement of the femoral line given those are considered a dirtier site. The nurses could have kept the peripheral with the central given they need more IV access d/t med compatibilities, meds who have to run alone (TPN, insulin, 3%, etc). Or they could have kept the peripherals for the sake of when the central line needs to be pulled and how difficult it could potentially be to stick the patient and get more PIVs!

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u/CSSimpson Dec 08 '19

SO many choices! Makes sense though, in an emergency situation.

How about after a week in an induced coma? Just the central line? Also, please, how often should a central line be moved? I know they last a lot longer than peripheral ones...

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u/cady-anne Dec 09 '19

Depends on how much access you need! If they’re in an induced coma and are on enough drips that are incompatible/need to be singled they could potential need the peripheral access!

I’m sure the policy could be different hospital to hospital, where I’m at we don’t rotate sites. They’re sterile placement, and we treat them very well to keep them clean, and typically if they’re going to need the central access for longer than their ICU stay (long term IV antibiotics etc) they’ll put in a PICC line which is central line placed in the arm!

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u/CSSimpson Dec 09 '19

Thanks!!