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30 Cards in this Set
- Front
- Back
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Central Venous Access: General Approach
The ... technique provides the benefit of obtaining central venous access without the inherent risks of using a large-bore needle. |
Seldinger wire-guided
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look at slides 17 – 25
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ok
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If you are trying to get subclavian central venous access and the patient has a pneumothorax on the right side, which side should you put the line in?
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right (on the side with the pneumothorax)
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What type of position should you place the patient before starting a subclavian central venous access?
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trendelenburg position
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What is the important landmark for all aspects of the internal jugular central venous access procedure?
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sternocleidomastoid muscle
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Why do you want to place the patient in a trendelenburg position before starting to access the internal jugular vein?
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It makes the vein swell (get bigger) due to the increased preload.
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If a patient is at high risk for a pneumothorax, is obese, has COPD, is an infant, or has an anatomic challange (i.e. scoliosis), which procedure would you use? Internal jugular cannulation or subclavian cannulation? Why?
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Internal jugular cannulation because the neck has vessels that you can compress (in order to control the bleeding) in case bleeding occurs.
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Internal jugular central venous access:
In critically ill patients in need of airway management, which sites of venous access are preferable? Which approach of the internal jugular venous access is preferred due to the consistency and reliability of the anatomic landmarks and the low risk of carotid puncture? which side of the neck is preferred? |
subclavian or femoral vein
middle approach right side |
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what is the pneumonic to remember the position of structures under the inguinal ligament?
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NAVL (from lateral to medial – towards navel)
femoral nerve, artery, vein, lymphatics |
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look at slides 46 – 49
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ok
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look at slides 59 – 60
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ok
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look at slides 68 – 71
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ok
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What is the main reason clinicians usually perform LPs for?
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possible meningitis
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What interspace level is at the level of the iliac crest?
What level does the spinal cord stop around usually? |
L4-L5 level
L1-L2 |
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look at slides 80 – 85
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ok
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LP:
Although 15 mL of CSF is sufficient to obtain all of the listed studies, the yield of fungal and mycobacterial cultures and cytology increases when larger volumes are sample. In general 20-30 mL may be safely removed from adults However, in my experience, I usually take about ... to ... ml of CSF/tube x 4 tubes Be sure to keep your tubes in ... (they come pre-numbered) |
1.5 to 2
order |
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What would you use in order to get fluid or pharmacologic support to a severely depressed neonate?
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umbilical venous catheter
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The umbilical cord has 2 ... and one ...
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arteries
vein |
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look at slides 96 - 97
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ok
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look at slides 101 - 104
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ok
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look at slides 112 – 115
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ok
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What is the contraindication for digital intubation?
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an awake patient
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look at slide 121
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ok
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look at slides 130 – 132
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ok
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What are the contraindications to tracheal suctioning?
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none
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Tracheal suctioning:
to enter the right mainstem bronchus, use a ... catheter to enter the left mainstem bronchus, use a ... catheter, turn the patient’s head to the ..., and ... the catheter on entry |
straight
curved-tip right rotate |
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Tracheal Suctioning:
advance with thumb ... the port remove with thumb ... the port |
off
on |
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look at slides 140 – 141
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ok
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Which catheter should you use to infuse large volumes in a short amount of time?
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chordis catheter
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What is the interspace of choice for an LP?
Bevel of needle needs to be ... if we are doing a lateral recumbant position |
L4-L5
up |
