Whether to monitor vitals, administer fluids, medications, or chemotherapy, chances are you’ll come learn first hand about lines and catheters. Until then, I think it is important for you to know what it means to get a line, where they are usually placed, and the risks versus benefits.
Below you’ll find a list of the most commonly lines and the reasons for use:
- Peripheral intravenous line (aka peripheral IV): The peripheral IV is one that you see regularly in most patients in the hospital. It is used to give fluids or medications. It is usually inserted on the back of the hand, near the wrist, or near the elbow. It is the least invasive type of line. This one rarely causes complications or infections.
- Internal jugular central line: This line is commonly seen in patients in the intensive care unit (ICU). It is used to administer a large amount of fluids (or medications) as quickly as possible and multiple fluids can be administered simultaneously. This line is located in the neck. It requires an experienced physician to place and does carry a risk of bleeding, infection, and pneumothorax (puncturing into the top part of the lung).
- Subclavian central line: This line is also commonly seen in patients in the ICU. It serves the same purpose as the internal jugular central line, but it does require a very experienced physician to place it. It is placed underneath the clavicle (collar bone). The risk is also bleeding, infection, and pneumothorax. The choice of placing an internal jugular or subclavian central line is based on the physician training and their personal preference.
- Femoral central line: This line is usually placed in an emergency situation, especially in the ER. It serves the same purpose as the internal jugular or subclavian central line. It is easy to find and easy to place. It is near your groin. Having said that, it should only stay in for a few days since it has the highest risk of infection because of its location.
- Peripherally inserted central catheter (PICC): It is inserted into a vein in the arm rather than a vein in the neck like the internal jugular or chest like the subclavian. It is commonly used in patients getting chemotherapy who are waiting for a port (a small medical appliance that is installed beneath the skin) to be placed. It is meant to be short term and should be removed in a few weeks.
- Port: This is the most preferred line for patients who are getting chemotherapy long term. It is a tunneled catheter placed on the chest underneath the skin. It is a surgical procedure so patients do need to be under general anesthesia. There is little risk of infection, and patients can even swim with it installed. It is mainly used for chemotherapy.
- Quinton line: This is placed mainly in the femoral or groin area. It is a big line used mainly for dialysis for some patients in the ICU with acute kidney injury or patients whose cancer cause kidney failure. It should only be used as a temporary measure until the kidney function normalizes.
- Arterial line: This is one of the most challenging line to place because the artery is small and hard to find. This line is risky as it can cause significant bleeding. It should only be used in ICU for patients who need accurate monitoring of blood pressure.
Be sure to watch for bleeding, infection and site irritation. If you see any of these, notify the doctor immediately.