Central line insertion

The CLAB-ICU Training Framework for central line insertion was developed by the Clinical Excellence Commission (CEC) and the Intensive Care Coordination and Monitoring Unit (ICCMU) for the CLAB-ICU Project – (CLAB = Central Line Associated Bacteraemia). This initiative, which was based on a seminal paper by Pronovost in 2006, simply promoted a standardised aseptic insertion technique. The results were impressive: in New South Wales between 2007 and 2010 there was an 80% reduction in CLABs.

As well as the training framework, the project also resulted in a very useful, standard sterile equipment pack for central line insertion, and an excellent, comprehensive online education package.

Getting accredited

1) Complete the CEC’s Central Line Insertion Online Training

Print off your quiz results (when you have passed!)

2) Watch the video on the use of ultrasound for central venous cannulation:

Note: Also see page on Performing an ultrasound scan – the basics if you are new to ultrasound

3) Print out and complete the RPA CVC Training Framework. The instructions for completion are in the document.

An overview of the Training Framework

Further reading

1) Pronovost P et al. An intervention to reduce catheter-related bloodstream infections in the ICU. NEJM 2006; 355: 2725-32.

2) Bodenham AR. Can you justify not using ultrasound guidance for central venous access? Critical Care 2006; 10: 175.

3) Fragou M et al. Real-time ultrasound-guided subclavian vein cannulation versus the landmark method in critical care patients: A prospective randomized study. Crit Care Med 2011; 39: 1607-12.

4) Bishop L et al. Guidelines on the insertion and management of central venous access devices in adults. Int Jnl Lab Hem 2007; 29: 261-78.

5) Marik PE et al. The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: A systematic review of the literature and meta-analysis. Crit Care Med 2012; 40: 2479-85.

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