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Central line bundle – insertion — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardIDCentral line bundle – insertionRACP Paediatrics

During PICU central venous catheter insertion, the operator performs hand hygiene and wears sterile gloves, but proposes a small fenestrated drape and no sterile gown because ultrasound guidance will shorten the procedure. What should the supervising physician do?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Pause and institute the full maximal-barrier and skin-antisepsis insertion bundle

Explanation lettering: E = shown as A · D = shown as B · A = shown as C · B = shown as D · C = shown as E

E is correct because a central-line insertion bundle includes hand hygiene, cap, mask, sterile gown and gloves, a large sterile drape, and appropriate chlorhexidine-alcohol skin antisepsis allowed to dry. A confuses ultrasound’s mechanical benefits with infection prevention. B systemic prophylaxis does not compensate for deficient asepsis and is not routine. C routine scheduled replacement is not recommended and adds procedural harm. D invents a universal paediatric contraindication; product, age and skin factors are assessed specifically. A trained observer should be empowered to stop a non-compliant insertion.

Reference: Queensland Health, vascular access device clinical management for infection prevention: https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/infection-prevention/vascular-access-device-management