Central Line Wizardry


    Central Line Wizardry

    I was scrolling through twitter this morning when I came across a quick video from @CriticalCareNow for an awesome central line trick. And then I went to his feed and found some more.

    They are pretty genius and I think I’ll start using a few.

    Check out Dr. Haney Mallemat’s twitter at @CriticalCareNow for video demonstrations! Link below.


    Trick #1: Stop running out of sterile flushes. Use a saline bag!

    You finally get your line in, go to reach for a flush, and realize you’ve used them all. Or you dropped one. Or a consultant is doing a procedure and starts asking for your entire ED supply of sterile flushes (based on true, recent events). Never again!

    -hang a saline bag prior to starting (grab a 250-500cc one if available, you won’t need a full liter)

    -open IV tubing onto your sterile field

    -hand off the spike end to an assistant

    -leave the connector end on your field for PRN use


    Trick #2: Lost your plastic sheath on the guidewire? Straighten it out!

    It happens. Despite your most cautious approach, things drop on the floor during your sterile procedures. Did you know you can straighten the J-tip of the wire out?

    -pinch the the straight part of the J-tip between your thumb and first finger and slide them over one another, which should straighten the tip out enough for you to insert the wire


    Trick #3: Be neat with that blood-covered guidewire!

    If you’ve ever pulled out a guidewire, you know that it’s covered in blood and usually very floppy, which can send blood flying everywhere. It also has a tendency to roll off which every surface you put it on–mayo stand, patient drapes, etc. A slick way to tidy up you guidewire like a pro is to put it back where it came from.

    -once your central line is inside the patient, simply guide the wire tip back into the plastic tubing it came from.


    If you want some more, dive into the TR Pearl archives for  Dr. Brendan Milliner’s post:





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