The preferred site of insertion (including for non-tunneled catheter placement), from an infection prevention point of view, is in the subclavian vein, and to generally avoid the femoral vein if possible. There is no clear recommendation for a tunneled catheter site in the guidelines. Selection of catheters should include those with minimal ports to accomplish the clinical goal. Sterile gloves are required for CVC Full body sterile drapes, cap, mask, gloves are required for placement of CVCs The catheter site should be monitored visually and with palpation (through dressing) on a regular basis to assess for infection. It is, however, acceptable to use clean, non-sterile, gloves for changing the dressing of intravascular catheters. Both chlorhexidine and povidone-iodine are acceptable skin cleansers, though chlorhexidine is preferred. For short-term CVC sites, dressings must be changed at least every 7 days for transparent dressings, and every 2 days for gauze dressings. For long-term implanted or tunneled catheters, dressings are to be changed no more than once weekly unless soiled or loose. Routine removal and replacement of a central venous catheter is not recommended. While central line catheters should be removed as soon as they are no longer necessary, scheduled removal and replacement, whether over a guidewire or with a new puncture site, has not been shown to be beneficial in preventing infections. Medication impregnated dressing products can reduce the risk getting catheter-related blood stream infection. There is inconclusive evidence whether longer interval of changing dressings for central venous access devices is associated with more or less infections. It is unclear whether cleaning the skin with antiseptics or without skin cleansing can reduce the rate of catheter-related bloodstream infections. The lack of clarity is due to the low quality of some of the studies used in the meta-analysis.
The preferred site of insertion (including for non-tunneled catheter placement), from an infection prevention point of view, is in the subclavian vein, and to generally avoid the femoral vein if possible. There is no clear recommendation for a tunneled catheter site in the guidelines. Selection of catheters should include those with minimal ports to accomplish the clinical goal. Sterile gloves are required for CVC Full body sterile drapes, cap, mask, gloves are required for placement of CVCs The catheter site should be monitored visually and with palpation (through dressing) on a regular basis to assess for infection. It is, however, acceptable to use clean, non-sterile, gloves for changing the dressing of intravascular catheters. Both chlorhexidine and povidone-iodine are acceptable skin cleansers, though chlorhexidine is preferred. For short-term CVC sites, dressings must be changed at least every 7 days for transparent dressings, and every 2 days for gauze dressings. For long-term implanted or tunneled catheters, dressings are to be changed no more than once weekly unless soiled or loose. Routine removal and replacement of a central venous catheter is not recommended. While central line catheters should be removed as soon as they are no longer nec,essary, scheduled removal and replacement, whether over a guidewire or with a new puncture site has not been shown to be beneficial in preventing infections. Medication impregnated dressing products can reduce the risk getting catheter-related blood stream infection. There is inconclusive evidence whether longer interval of changing dressings for central venous access devices is associated with more or less infections. It is unclear whether cleaning the skin with antiseptics or without skin cleansing can reduce the rate of catheter-related bloodstream infections. The lack of clarity is due to the low quality of some of the studies used in the meta-analysis.