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  • Jill  - The blue clips for securing CVCs
    Good talk but perhaps ED physicians don't get great feedback about line securing because the line usually stays put until they leave your department and then it becomes someone else's problem.

    But the method you've talked about for securing CVCs is a real safety issue with central lines in ICU or the wards. You should never use the white/blue clip on device to secure the CVCs as you can easily pull a central line out (under the weight of infusion lines or patient movement,etc) with that clip on. Better to secure the line to the skin with silk sutures both at the point where the line goes into the skin and again at the fixed hub at the distal part of the line. There's a number of techniques to do that. Ditto if you only secure the distal hub and have left a length of the line outside the skin, it's easy to pull the line out whilst your sutures stay attached.

    Lines secured using the clips come out quite frequently and result in complications for the patient (eg large volumes of infusions into the subcut tissue of the neck causing airway compromise or tissue necrosis due to the drug infused).

    When patients come into our ICU with those clips we make it a priority to secure the line properly to save on mortality and morbidity for our patients.
  • charlie  - FP doc
    Great talk. The cordis line is the best line for any penetrating trauma (knives, GSW's) because you can get the line in quickly and infuse O neg blood from a pressurized bag much faster than through a TLC.
  • KIM  - C-line
    It would be very useful and practical for the patients. It would be more easy if you talk more slowly when you guide the location of the puncture site. But personally I don't any procedure. Thanks a lot. Doctor
  • samuel.kippenberger@my.mcphs.e  - EM Rap central lines
    Central lines talk from USC
  • medman  - bsn rn
    very interesting lectures..
    thanks
    u of penn (hup)
  • JJ  - MD
    Best talk I've seen on central lines.. Thanks!
  • anita sandison BM MRCP FRCA  - Compliments from over the pond
    Thank you very much for an excellent, animated and informative presentation. I was transfixed for the entire time. Please do it again harry
    xxx