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