Central Line Worries

The night was going perfectly.  It was 3:15 am and I was sitting in my pod between my two patients rooms.  Suddenly, one of their pumps starts beeping.  This is not uncommon and happens when an infusion is complete, sometimes when the patient moves, or just because the pump is being stubborn. I glance into my patients dark room to view the pump and see that it reads “occluded – patient side”, so I get up and walk into her room to find her holding her central line in her hand.  She looks at me and says “it’s all wet” . . . !!!

Immediately I grab some sterile gauze and place it over her neck which is bloody.  Her insulin drip and saline are now soaking her bed.  Central lines are run through a large vein, in this case it was the internal jugular vein which drops straight into the heart.  Extreme care is taken when dealing with central lines as they are such large veins so close to the heart.  Patients run the high risk of bleeding or infection with central lines, but for many patients it is the only IV access and is the best access for many ICU patients on several drugs.

 

This little lady had become confused and agitated and within the 15 minutes from when I last was in her room to this point had managed to pull the 12 inch line clear out of her neck.  Luckily we were able to regain access to a small vein in the hand.  Calling the physician on this was not fun!  The patient is stable and doing well.