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13 Cards in this Set

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  • Back
what are central lines?
catheters placed into the major veins (central veins) via subclavian, internal jugular, or femoral vein approaches
what major complications result from placement?
PTX (always obtain postplacement CXR), bleeding, malposition (e.g., into the neck from subclavian approach), dysrhythmias
in long-term central lines, what does the cuff do?
allows ingrowth of fibrous tissue, which: 1. holds the line in place and 2. forms a barrier to the advance of bacteria
what is a hickman or hickman-type catheter?
external central line tunneled under the skin w/a cuff
what is a port-a-cath?
central line that has a port buried under the skin that must be accessed through the skin (percutaneously)
what is a cordis?
large central line catheter; used for massive fluid resuscitation or for placing a swan-ganz catheter
if you try to place a subclavian central line unsuccessfully, what must you do before trying the other side?
get a CXR --> a bilateral pneumothorax can be fatal
what are the signs of a central line infection?
UNEXPLAINED HYPERGLYCEMIA, fever, mental status change, hypotension, tachycardia --> SHOCK, pus, and erythema at central line site
what is the most common cause of catheter-related bloodstream infections?
coagulase-negative staphylococcus (33%), followed by enterococci, staphylococcus aureus, gram-negative rods
when should central lines be changed?
when they are infected; there is NO advantage to changing them every 7 days n nonburn patients
what central line infusion increases the risk of infection?
hyperal (TPN)
what is the tx for central line infection
1. remove central line (send for culture) +/- IV antibiotics. 2. place NEW central line in a different site
when should peripheral IV short angiocatheters be changed?
every 72-96 hr.s