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Gina Ward
juglar lines (short peripheral cath) being treated as a central line with insertion bundles


I was in a meeting regarding the "Aim for Zero" project and the ER director brought up a question.


When a short peripheral  catheter  is inserted in the ER in the external juglar ( I dont think they place short peripheral caths in the internal do they?? )  does it still require the full Central line insertion bundle? 

She had heard somewhere that it required the same treatment upon insertion because it was in a central versus peripheral vein. I am aware of the need for bundle if using the vein for insertion of a central catheter where the tip will lie in the SVC but not for just a short catheter.


P.S. while we are thinking, if you remove a short peripheral cath from the external juglar do you need to do the same air embolism prevention protocol? 


thank you in advance for your responses. 

Gina Ward R.N., CPAN


You have brougt up the million dollar questions of no answers

Recently hospitals have been placing short EJ's. midlines, and more PIV's to avoid reporting CLA-BSI's.  Hopefully the CDC will change their definition to all VAD's regardless of type and that party will end.  Avoiding reporting infections is not the reason to use a device that might not be the best device.  In fact they are running vesicants and TPN via these short IJ's.  So does an IJ need full bundle.  It is a peripheral so therefore I guess not however, it is just a peripheral and should be treated as such except when it comes to the air embolism as not it is a central line with the potential for an air embolism to occur.  I believe we need standards related to this EJ usage.  Maybe Lynn Hadaway can give us what the INS Standards say in regards to EJ insertion and removal


A short peripheral catheter

A short peripheral catheter inserted into the EJ vein would fall under the same guidelines as any other peripheral catheter. This is a superficial and peripheral vein. So the same insertion procedures, guidelines for types of therapies for infusion, length of dwell etc would apply. If the EJ is used for a catheter that extends into the thorax and/or is intended for longer term dwell, then the same guidelines for all other CVCs would apply. At least this is the way I would approach these issues. So it would be a matter of the type of catheter used, the type of therapy infused and the length of time it is to be used that would direct these decisions, in my opinion. There is no much research on this site so not a lot of evidence yet. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Christine Thomas
EJ placements

Maybe I am too cautious but since there is not enough data and the implications of an extravasation of an EJ peripheral catheter are troublesome,  I made the guideline at our hospital that EJ peripheral IV's are only placed as an emergency vascular access until a reliable line can be placed.  i have discussed this with staff and feel that this quick fix should not be promoted in ER. 


Just my opinion.


Chris Thomas, RN, MSN, CNP

Manager of Vascular Access

Fairview Hospital of the Cleveland Clinic

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