Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
CVP monitoring, PA monitoring/CV oximetry, transvenous pacing, temp HD, drug admin, fluid resuscitation, aspiration of air emboli, difficult peripheral access, freq blood draws.
|
Indications for central line
|
|
RA tumor/clot/TV lesions, surgery (CEA) on ipsilateral side, anticoagulation, prior neck surgery, SVC syndrom?.
|
Contraindications for central line
|
|
All vessels are near_____
|
Nerves
|
|
Infection, air or thrombus embolism, arrhythmias with placement, hematoma, nerve trauma
|
Complications at all sites of insertion
|
|
Short, valveless course to the SVC
|
Pro of IJ site
|
|
Consistent location, palpable landmarks, easy access, high success rate
|
Pros for IJ site
|
|
IJ site is close to ________ nerve
|
Brachial plexus/phrenic
|
|
Pneumothorax, airway compromise if hematoma, hemothorax, chylothorax, cardiac tamponade.
|
Cons for IJ site
|
|
Lower rate of infection, higher pt comfort after insertion
|
Pros for SC vein site
|
|
SC site is easier to perform in trauma pts with :
|
Immobilized c-spine
|
|
Higher incidence of pneumothorax; hemothorax, chylothorax, cardiac tamponade
|
Cons for SC vein site
|
|
SC vein is not _______ in case of hemorrhage
|
Compressible
|
|
SC vein is not a good site for a ________ pt
|
Coagulopathic
|
|
Eliminates many of the complications associated with other sites and is useful in emergencies (reliable anatomy, not in proximity to the airway)
|
Femoral vein site
|
|
Best and worst for long term use:
|
SC, femoral
|
|
Best and worst for ease of cannulation:
|
IJ, SC
|
|
Best and worst for success rate:
|
IJ, femoral
|
|
Best and worst for complications- technique related:
|
Femoral, subclavian
|
|
RIJ distance from insertion site to RA
|
20 cm
|
|
LIJ distance from insertion site to RA
|
25 cm
|
|
SC distance from insertion site to RA
|
15 cm
|
|
Femoral distance from insertion site to RA
|
50 cm
|
|
Preferred technique for line insertion, all sites:
|
Seldinger
|
|
EJ is considered a ______
|
PIV (use an 18 GA)
|
|
Do not place a TLC in the EJ b/c it is
|
Too tortuous
|
|
For IJ and SC sites, use of _____ may help with insertion
|
Trendelenburg
|
|
Small gauge needle used to verify location of vessel when using the landmark technique for IJ placement
|
Seeker
|
|
Blood color, non pulsatile, ABG, transducer (IV extension tubing):
|
Verification when using the landmark technique for IJ placement
|
|
When using u/s, you use the ____ axis for locating the vessel location
|
Short
|
|
You can use the ______ to verify placement for all techniques.
|
CVP tracing
|
|
The catheter tip should be just superior to or at the junction of the _____ and the RA
|
SVC
|
|
The catheter tip should be _____ to the vessel walls.
|
Parallel
|
|
The catheter tip should be _____ the inferior border of the clavicles.
|
Below
|
|
The catheter tip should be above the level of the _______ interspace/carina
|
3rd rib/T4-5
|