Procedures-Central Line Insertion

Front 1

When are central lines used?

Back 1

when there is a need for:
-frequent or intensive cardiovascular monitoring
-use of heart failure drugs in some pts eg: dopamine and other inotropes
-assessment of fluid status
-increased viability of intravenous drugs/fluids

Front 2

What veins are most commonly used in central lines?

Back 2

-internal jugular
-subclavian
-femoral

Front 3

Name 4 indications for central line placement.

Back 3

1-monitoring the central venous pressure in acutely ill pts to quantify fluid balance
2-parentral nutrition
3-need for IV therapy when peripheral venous access is impossible
4-when pt needs drugs that are prone to cause phlebitis in peripheral veins

Front 4

Name 5 meds drugs that can cause phlebitis, so it is better to give via central line

Back 4

1-calcium chloride
2-chemo
3-KCl
4-amiodorone
5-IV antibiotics

Front 5

Name 4 contraindications to central line placement.

(beware, there are 16 of them and will be covered in the next 4 questions)

Back 5

-infection over insertion site
-distortion of landmarks from any reason
-suspected injury to the superior vena cava
-coagulopathies including anticoagulation therapy

Front 6

Name 4 more contraindications to central line.

Back 6

-pneumothorax or hemothrox on the contralateral side
-inability to tolerate pneumothorax on the ipsilateral side
-uncooperative pts
-pts unable to tolerate a Trendelengerg position

Front 7

Name 4 more contraindications to central line

Back 7

-prior injury to that vein
-morbid obesity
-recently discontinued subclavian catheter at the same location
-planned mastectomy on the side of subclavian insertion

Front 8

Name 4 more contraindications to central line.

Back 8

-pts receiving ventilatory support with high end expiratory pressures
-pts with vigorous, ongoing cardiopulmonary resuscitations
-children less than 2 years
-fx or suspected fx of ipsilateral upper ribs or clavicle

Front 9

What are 5 benefits of central line placements.

Back 9

1-permits infusion of solutions containing medication or nutritional substances without causing complications that occur with an IV
-simple and painless means of drawing blood, giving meds, nutrients or both
-great solution for those needing chemo
-may be used immediatley after placement
-easily removed when no longer needed

Front 10

Name 5 risks of central line placement>

Back 10

-damage to blood vessels, bruising or bleeding at the puncture site
-bleeding
-penumothorax
-arrhythmia
-infection

Front 11

Name 4 more risks of central line placement

Back 11

-catheter dislodgement
-air embolism
-clotting
-vein occlusion

Front 12

What size needle do you use to insert lido in central line insertion?

Back 12

27 guage needle

Front 13

Read the procedure on central line placement?

Back 13

because I am lazy

Front 14

Once central line is placed, what to you have to ensure?

Back 14

ensure that fluid runs in freely and that blood flows freely back

Front 15

What do you always do after you place a central line?

Back 15

a CXR to make sure placement is correct and to check the position of the catheter tip and to exclude pneumo, hydro or hemothroax