Insertion and use

The area over the vein that has been chosen for tunnelled CVC insertion is disinfected and anaesthetised.

Aseptic techniques must always be followed when inserting CVCs, attending to the site of the tunnelled CVC, and changing dressings.

The right internal jugular is the preferred vein for inserting CVCs because it has straight course to the right side of the heart, and therefore the lowest risk of the venous stenosis and thrombosis. However, CVCs may also be inserted into the subclavian or femoral veins.

A vascular access specialist (VAS) makes a small cut in skin above the vein and the tunnelled CVC is inserted. 

X-ray imaging or other imaging technology are used to check the location of the catheter is correct

Lumens of tunnelled CVCs are flushed with saline before, and after, use to preserve patency of the catheters lumens. 

After insertion, a sterile dressing is applied and maintained on the insertion site until it is well healed.