Question

A client in the acute setting has difficult vascular access. The provider has placed a Groshong central venous catheter in place. Where is the insertion site for this central venous catheter? What indications can this central venous catheter be used for? How long can this central venous catheter be kept in place?

Answer 1

Answer:

Central venous lines are vascular access lines that are only used when a patient will receive treatment that requires a main vein, not accessible through normal venous punction, or, when the treatment will extend for a long period of time. One such central lines is the Groshong central venous catheter, that it very comfortable due to its functionality, decreased risks for complications, and its easy maintenance. However, as it is still a line that goes from the outside directly into the major blood vessels, and near the heart, it is still something that needs extreme care on the part of healthcare professionals.

1. The site of insertion of this type of central line is on the chest, near the clavicles, seeking the subclavian vein, to lead all the way to the superior vena cava, and close to the juncture between this vein and the atria of the heart.

2. The indications for the use of this line are: long exposure to treatment with difficulty of access to less central vessels, when the medication, fluids, or nutrition that will be given can damage periferal veins, or their volume is superior to what periferal veins can contain, and finally, when there will be a prolonged exposure to treatment, like in the case of chemotherapy.

3. The catheter is highly favored in hospital settings due to its easy maintenance and also due to its durability. Unless something goes wrong, or the catheter is damaged, or exposed in some way, its duration can go to three weeks, when tissue  begins to form around the catheter´s insertion site. It must be removed immediately if any signs of leaking, inflammation, or infection, appear around, or if there are signs of closure on one of the lines inside the catheter.