Central venous catheterization may not be attempted until accredited to do so. Accreditation will form a part of the introduction to the Intensive Care. Registrars will be required to perform 2 arterial catheter insertions, and 5 central venous line insertions under supervision prior to being accredited.
IV access in intensive care patients
Hypertonic solutions (Amiodarone, nimodipine)
Infusions of inotropes or other vasoactive substances
Monitoring of right heart pressures (CVP, Pulmonary Artery Catheter and cardiac output)
Access for renal replacement therapy
Large bore resuscitation catheter: PA sheath or dialysis catheter
CVC insertion technique will be taught during the orientation
All procedures must be performed under conditions of strict "asepsis"
Where a junior member of staff is familiar with a certain technique, they should continue to use that technique.
If you suspect that you have mistakenly cannulated an artery rather than a vein, seek assistance from the senior Registrar or duty Intensive Care Specialist prior to removing the offending line.