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• Hickman, Broviac, and Leonard catheters are placed surgically and threaded under the skin TYPES OF CENTRAL LINES • Central venous catheters may have 1, 2, or 3 lumens • TPN is given through a dedicated port • Blood products are given through an 18-20 gauge or larger infusion port • Dual Lumen Lines • Some dual lumen catheters have both lumens open at the distal end of the catheter • Be cautious with incompatible medications • Be aware of possible contamination of blood sample if drawing blood from one port while the other supports infusion of IV fluid, blood, or medication TYPES OF CENTRAL LINES • Triple Lumen Lines • Staggered lumen openings • Incompatible medications may be given at the same time • Blood sampling should be through the proximal port to avoid contamination by fluids and medications from the other ports • CVP monitoring is measured at the distal port TYPES OF CENTRAL LINES • PICC – Peripherally Inserted Central IV Catheter • Usually inserted in the upper arm • Catheter tip is in the distal superior vena cava like all other central lines • Midlines are NOT central lines TYPES OF CENTRAL LINES • Groshong - 3 way pressure sensitive slit at the catheter tip • doesn’t require clamping or heparin flush • flushed with saline q week • Groshong tip catheters are usually blue • Design used in tunneled catheters and some PICC lines TYPES OF CENTRAL LINES • Hickman/Broviac/Leonard – Open-ended, no valve • Inserted surgically and threaded under the skin • Usually inserted in the subclavian vein with the tip 2-3 cm from the right atrium • Flush with Saline and Heparin after use & every day TYPES OF CENTRAL LINES • Hickman, Broviac, and Leonard Catheters – Open-ended, tunneled central lines • Hickman catheters can be 1, 2, or 3 lumen • The lumens may all be identically sized, or • The lumens may be of different sizes • Broviac catheters are all single lumen catheters • Leonard catheters have 2 lumens of identical size IMPLANTABLE DEVICES • Implanted subcutaneously instead of patient having a port outside of body • Mediport and Portacaths are the most common • No dressing is required • Accessed by a Huber needle • Flushed with Heparin • More expensive Mediport or Portacath • A portacath or "port" is comprised of two components, a self-sealing injection port and a catheter that enters the vein