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INTRODUCTION
Over 5 million central venous catheters (CVCs) are inserted yearly in the United States. (1) Establishing central venous access is an essential skill for emergency physicians and is a core competency for emergency medicine residency training. (2)
The indications for CVC insertion include hemodynamic monitoring, temporary cardiac pacemaker, hemodialysis and lack of peripheral venous access. With the recent landmark sepsis trial, hemodynamic monitoring with central lines is likely to increase. (3) Insertion of CVCs continues to be associated with complication rates as high as 18%. (4,5) Potential immediate complications are listed in Box 1.
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