What’s the difference between a central line and an IV?


What’s the difference between a central line and an IV?

In: Biology

A central line (CVC) is much longer and ends up all the way near the heart, or even just inside the heart. It’s used when you need to give medicine/fluids that would harm smaller veins, especially when you need a large volume. It can also be used to take blood tests or run nutrition.

Some further types of lines:
Peripheral IV: temporary, for a few days of access, or just long enough to draw blood give a medication. Think about the big vein in your elbow aka antecubital fossa.

Midline: a longer catheter that starts peripheral and doesn’t go all the way to near your heart. Kind of a middle child, intended for medium term use, liked because it is easier to place and doesn’t require as much confirmation of placement.

PICC: a long catheter that starts peripheral and goes to near your heart, usually superior vena cava or cavoatrial junction. Like a midline, intended for medium term use, but can tolerate larger volumes and more caustic medications.

Dialysis catheter: a very large bore central line, temporary, for a few days, that is named for the ability to handle super high volume needed for dialysis or pheresis.

Tunneled lines: any line that goes through your subcutaneous fat for a while then goes into your venous system. These lines can last for a long time, because the tunneling process reduces the risk of infection.

Port a cath: a little plastic box with a rubber cover, can be accessed with a side hole needle aka noncoring aka Huber needle. These are implanted subcutaneously and tunneled, and can be used thousands of times, and kept for years. You have a little box under your skin, so you can shower and swim and people like these. If you’re cachectic, though, that is, lack adequate fat to cushion the box, you can have some terrible problems. Afaik the lowest risk of infection.

Tunneled dialysis catheter (and other large bore tunneled lines like the Hickman or pheresis catheters): a tunneled large bore catheter that can tolerate the high volume needed for dialysis or pheresis. At least two lumens (two tubes) so you can have an in and an out. Teams love to ask for this in an unstable patient because they don’t want to put in a temporary dialysis catheter, they’d rather you put this in which can last for weeks or months as a bridge to a fistula or something. You need to be firm if you think the patient is going to code while you put it in or the patient is bacteremic and it will require replacement. Not as comfy as a port a cath, because you will always have lines coming out of your skin that need protection.

Intraosseous: for use by EMS or in patients that are so messed up you just can’t get access any other way. Literally a handheld drill with a huge needle that you drill into the patients shinbone. Very high volumes ok. Much hurts. Very ouch. Wow.

Arterial line:
Usually only in ICU setting, extra monitoring info, e.g. continuous arterial blood pressure info. Other parameters depend on what kind of catheter is used to get arterial access, but most commonly is a temporary peripheral line.

Umbilical line: can be venous or arterial, used in neonates that are very difficult to access. Be aware that neonates have vascular anatomy that is different from adults!

ECMO lines: like temporary dialysis catheters, but even more high volume lines, rather than one big double lumen line, you’ll need two lines, one for in and one for out. This is another ICU / OR maybe ED line.

Wish I could tell you about Swan Ganz / other Cardiology type lines and about IR/vascular surgery lines and wires.