A "central line" is a type of intravenous catheter that is inserted into one of the larger veins of the body, typically the superior vena cava, which can be accessed by either the internal jugular vein or, more rarely, the subclavian vein.
A "central line" is also a great cause of fear and trepidation for many med students and junior residents. I recently successfully placed my first central line under with ultrasound guidance and close supervision on an intubated patient. Placement of the line requires inserting a 3-4 inch needle into the neck or chest while avoiding any of the following scenarios:
1) Nicking the carotid artery and watching your patient spurt blood from his neck like a cheap zombie apocalypse flick
2) Puncturing the lung (more likely with a subclavian line) and causing a pneumothorax in which the lung collapses as its surrounding negative pressure space fills with air.
3) Stabbing the heart itself with the long guidewire over which the catheter itself is slid; this is a particularly undesirable possibility as large hunks of raw meat typically do not respond well to poking and prodding. Ask any cow.
4) Failing. In this scenario you can't get your needle in the vein and the patient either dies or (and possibly more dreadfully for many individuals) a more senior medical staff has to save your incompetent derriere.
5) Incurring the wrath of a sickly patient who does not take kindly to being treated as a pin cushion; in this scenario the patient may run the risk of breaking the sterile field by squirming, spitting, swinging fists at your petrified face, or possibly snatching the needle from your trembling hand and attempting to place a central line in YOUR neck.
