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Principles2 > Art lines and CVCs > Flashcards

Art lines and CVCs Flashcards

1
Q

what % of pts lack collateral blood flow?

A

5%

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2
Q

after releasing pressure on the ulnar artery, flushing of the thumb confirms adequate collateral blood flow within how many seconds?

A

5 seconds

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3
Q

what phenomenon has preexisting vascular insufficiency? (RP)

A

raynaud’s phenomenon

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4
Q

Radial, brachial, ulnar, axillary, dorsalis pedis, or femoral artery:

  1. increased incidence of infection and arterial thrombus?
  2. don’t attempt if radial artery punctured?
  3. high rate of kinking?
  4. most common artery?
  5. distorted waveform and far distance from aorta?
  6. possible nerve damage and air/thrombi has quick access to cerebral circulation
A
  1. femoral
  2. ulnar
  3. brachial
  4. radial
  5. dorsalis pedis
  6. axillary
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5
Q

what gauge is the arrow catheter?

A

20 gauge

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6
Q

what gauge is the TB syringe needle?

A

27 gauge

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7
Q

Degrees:

  1. What degree do you penetrate the artery at?
  2. What degree do you drop the needle down to before advancing it 1-2 mm?
A
  1. 45 degrees

2. 30 degrees

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8
Q

what device do we use to monitor perfusion adequacy to the limb the art line is in?

A

pulse oximeter

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9
Q

Phlebostatic axis:

  1. located at which intercostal space?
  2. how far between the anterior-posterior diameter of the chest?
A
  1. 4th ICS

2. halfway between AP diameter of the chest

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10
Q

how many million CVCs are placed in the U.S. per year?

A

5 million

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11
Q

what % of central line insertions have complications?

A

15%

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12
Q

hematoma and arterial puncture are most common during which venous catheterization?

A

femoral

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13
Q

IJ or SC:

  1. more complications with pneumothorax?
  2. more complications with arterial puncture & hematoma?
A
  1. SC

2. IJ

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14
Q

does SC or IJ have lower incidence of infection?

A

SC

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15
Q

what is overall incidence % of infection in all CVC line sites?

A

2%

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16
Q

incidence of catheter related infection rises with the number of days the catheter is in past what day number?

A

3

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17
Q

incidence of infection with antiseptic coated catheters is reduced how many fold?

A

4 fold

18
Q

Thrombosis complications:

  1. what % of MICU patients get a catheter related thrombosis?
  2. what % of femoral catheters have a thrombosis?
  3. what % of subclavians have a thrombosis?
  4. IJ thrombosis is how many times a greater risk than subclavian?
A
  1. 15%
  2. 21.5%
  3. 1.9%
  4. 4 times
19
Q

chlorhexidine prep decreases catheter infection how many fold?

A

4 fold

20
Q

antibiotic coated catheters lower infection rate by what %?

A

50%

21
Q

inability to place CVC after 3 attempts increases complications how many fold?

A

6 fold

22
Q

practitioners with greater than 50 catheterizations have what fraction of less complications?

A

half

23
Q 
Femoral placement:
what are 3 advantages?
1. high rate of what? (S)
2. no interference with what? (C)
3. no risk of what? (P)
what are 4 disadvantages?
1. increased what? (I)
2. increased what? (D)
3 decreased pt what? (M)
4. increased circulation time of what? (D)
A
  1. success
  2. CPR
  3. pneumothorax
  4. infection
  5. DVTs
  6. mobility
  7. drug
24
Q 
IJ placement:
what are the 4 advantages?
1. optimal access for who? (A)
2. what complication is uncommon? (P)
3. increased rate of what? (S)
4. what is controlled easily? (B)
what are the 4 disadvantage?
1. poor landmarks in what pts? (O)
2. not ideal for what type of access? (P)
3. increased incidence of what? (I)
4. difficult access for emergent what? (I)
A
  1. anesthesia
  2. pneumothorax
  3. success
  4. bleeding
  5. obese
  6. prolonged
  7. infection
  8. intubations
25
Q

Does L or R IJ placement have an increased risk of thoracic duct injury?

A

L IJ

26
Q 
SC placement:
what are the 3 advantages? (IC, BOL, LII)
1. increased what? (C)
2. better landmarks in what pts? (O)
3. lower incidence of what? (I)
what are the 6 disadvantages?
1. increased risk of what? (P)
2. what is required for successful placement? (E)
3. frequent catheter what? (M)
4. inability to access from where? (H)
5. difficult placement during what? (C)
6. difficulty to control what? (B)
A
  1. increased comfort
  2. better obesity landmarks
  3. lower infection incidence
  4. pneumothorax
  5. experience
  6. malposition
  7. HOB
  8. CPR
  9. bleeding,
27
Q

what is the site choice for severe hypovolemia?

A

subclavian

28
Q

The right IJ runs __1.____ to the sternocleidomastoid muscle in the upper neck, ____2.___to it in the triangle of the between the two inferior heads of the sternocleidomastoid muscle (SCM) in the middle of the neck, and ____3.___ the anterior portion of the clavicular head in the lower part of the neck.

A
  1. medial
  2. posterior
  3. behind
29
Q

What is the proper CVC cm depth range for:

  1. right subclavian
  2. right IJ
  3. left IJ
A
  1. 13-14 cm
  2. 15-16 cm
  3. 17-18 cm
30
Q

Lateral or medial of the femoral pulse?

  1. vein
  2. nerve
A
  1. medial

2. lateral

31
Q

what insertion needle angle?

  1. subclavian
  2. femoral
A
  1. 15 degrees

2. 45 degrees

32
Q

intrajugular vein should not be deeper than how many cm?

A

2

33
Q

the subclavian vein in an adult is what range of cms long and what range of cms in diameter?

A

3-4 cm long & 1-2 cm in diameter

34
Q

what are the cm to right atrium?

  1. subclavian
  2. right IJ
  3. left IJ
  4. femoral
  5. R AC
  6. L AC
A
  1. 15 cm
  2. 20 cm
  3. 25 cm
  4. 30 cm
  5. 40 cm
  6. 45 cm
35
Q

what are the cm to right ventricle?

  1. subclavian
  2. right IJ
  3. left IJ
  4. femoral
  5. R AC
  6. L AC
A
  1. 25 cm
  2. 30 cm
  3. 35 cm
  4. 40 cm
  5. 50 cm
  6. 55 cm
36
Q

what are the cm to right pulmonary artery?

  1. subclavian
  2. right IJ
  3. left IJ
  4. femoral
  5. R AC
  6. L AC
A
  1. 40 cm
  2. 45 cm
  3. 50 cm
  4. 55 cm
  5. 65 cm
  6. 70 cm
37
Q

A wave:

  1. increase atrial pressure cause by what?
  2. correlates with what wave on an EKG?
A
  1. R atrial contraction

2. P wave

38
Q

C wave:

  1. slight elevation of the tricuspid valve into the R atrium during when?
  2. correlates with the end of what on an EKG?
A
  1. early ventricular contraction

2. QRS segment

39
Q

X descent:

  1. probably caused by the downward movement of the what during systolic contraction?
  2. occurs before what wave on an EKG?
A
  1. ventricle

2. T wave

40
Q

V wave:

  1. what causes this wave?
  2. occurs as what wave is ending on an EKG?
A
  1. blood filling the right atrium comes up against a closed tricuspid valve
  2. T wave
41
Q

Y descent:

  1. what produces this descent?
  2. occurs before what wave on an EKG?
A
  1. tricuspid valve opens and blood goes to the right ventricle
  2. P wave

Principles2 (21 decks)

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