Central Line Safety Project

Brought to you by Haru Okuda, MD FACEP

NYCHHC Institute for Medical Simulation and Advanced Learning (IMSAL)

and

Scott Weingart, MD FACEP

EMCrit.org

Video Notes:

To view the videos on this page, you will need Quicktime. If you need a copy go to the apple website
These videos are quite large, so be patient.
If you want to view them in your web browser, simply click on the link
To download to your desktop, right click on the link and choose "save as."

Sterility

In the ED, there are only two ways to place central lines:

Full Sterile

       or

Non-Sterile

There is no in-between. Sometimes (hopefully rarely), the exigencies of time or patient condition will prevent placing a full sterile line. This is acceptable so long as you inform the accepting service that the line is not full sterile. If however you state the line is full sterile, you are in effect

Swearing on Your Patient's Life

that EVERY single step of the sterile placement process was followed without breaks. If you can't swear on your patient's life that this is true, then just say to the accepting service that the line was non-sterile and they will replace it.

Here is a video of how to place a full sterile line

Sterile Central Line Placement

Download the Full Sterile Line Placement video (Right-click and choose "save as". Quicktime MP4 Format)

Update for the new HHC bundle

How to Place a Line

How to perform a blind IJ line placement with all of the steps

Placing a Central Line (Quicktime MP4)

How to perform an infraclavicular subclavian line, with just the steps that are different from the IJ

Subclavian Line (Quicktime MP4)

How to Place a Sheath Introducer (Cordis)

Sheath Introducer Placement (Quicktime MP4)

Tough Situations

Are you in the Artery or the Vein?

How to tell (Quicktime MP4)

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Special thanks to John Ponessa for editing wizardry and Tim Clapper for the educational development.