Assessment, monitoring and ward skills

Central lines, arterial lines and invasive-device safety

Overview and approach

Invasive devices require a current indication, aseptic care and removal plan.

  • Your hub notes cover arterial and central line insertion, tracheostomy and chest tubes as ICU skills; images stay in the hub.
Assessment and clinical features

Assess site, function, perfusion, infection, bleeding and ongoing need.

  • Central line complications: infection, thrombosis, pneumothorax.
  • Device-related infections to monitor: central line bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI) and ventilator-associated pneumonia.
Differentials and investigations

Use appropriate placement/complication checks and targeted cultures when indicated.

  • Suspected line sepsis: blood cultures before antimicrobials where this does not delay urgent treatment (1).
Management and follow-up

Provide trained insertion/manipulation and local device-care bundles; review necessity daily.

  • Access types: peripherally inserted central catheter (PICC) for extended courses; tunnelled central catheter and implanted port for long-term therapy; non-tunnelled central catheter for short-term acute use. The PICC versus central comparison image is on the hub.
Red flags and clinical pearls

New hypoxia after insertion, arterial compromise or suspected line sepsis needs urgent review.

References
  1. Australian Commission on Safety and Quality in Health Care: Sepsis Clinical Care Standard

Last updated from Sen’s notes on 9 October 2026.