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Central venous access infection avoidance — ABEM Board MCQ

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ModerateProcedures and resuscitationCentral venous access infection avoidanceABEM Board

A 69-year-old man in septic shock needs vasopressors after peripheral IV failure. Triage acuity is ESI 1; BP 78/42 mm Hg despite fluids, HR 132/min. Ultrasound shows a compressible right internal jugular vein. Coagulation studies are not severely abnormal. Which of the following is the most appropriate next step in management?

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Correct answer: D — Place an ultrasound-guided internal jugular central venous catheter using maximal sterile barriers

Central venous access for vasopressors should be placed with ultrasound guidance when available and maximal sterile barrier precautions.

Reference: CDC central line infection prevention guidance; Surviving Sepsis Campaign