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Gina Ward
which is preferred a femoral vein for a central line or an intraosseous


We are working on our "Aim for Zero" which is an HCA project on preventing BSI with central lines.  We were discussing femoral

lines and avoidance of etc.  The ER director was wondering what would be best an IO or a central line in a femoral vein?  What is the

general opinion on this.  I am starting to think that a IO might be much less risk of infection because it is not even a central line and of

course once the pt is hemodynamically stable you can hopefully acces a peripheral site or a central line in a much cleaner area.  I am not

very familiar with  IOs  but I would also think that it may not be near as good for rapid volume replacement or multiple drugs  since it is

a single line.


If a femoral line is used, I thought the general plan was to remove it in 24-48 hours and put in a better line wether peripheral or central in a better location is that correct? 

I appreciate any feedback.  Thanks, Gina Ward R.N., CPAN

All infection prevention

All infection prevention guidelines are now stating to avoid the femoral sites and if you must use it, to avoid puncture directly in the inguinal area. Most now say to go below this area, but can you safely do this without US. In am emergency do you have time for use of US? . IO is only recommended for max of 24 hours, but you can infuse large volumes, and all drugs very rapidly plus gain access very rapidly. Reports of infection risk are far greater with femoral sites. Reports with IO complications show very low rates but I am not sure that you can correctly compare these 2 sites for complication risks. IO would definitely be faster and appropriate for resuscitation and the first 24 hours only. Lynn

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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