Central line Flashcards
indications for CL (7)
Monitoring central venous pressure
Infusion of caustic drugs
Administration of TPN
Aspiration of air emboli
Insertion of transcutaneous pacing leads
Venous access for people with poor peripheral veins
Dialysis access
Places for CL (4)
External jugular
Internal jugular
Subclavian-
Femoral-
Contraindications for CL (4)
Renal cell tumor extending into right atrium
Tricuspid valve vegetation
Site infection
Site specific
complications for CL (5)
Pneumothorax/Hemothorax
Line-related infection
Carotid puncture
Dysrhythmias
Trauma to nearby nerves
What is the reason for trendelenburg for CL insertion (2)
to decrease risk of air embolism
increases venous return (bigger vessel)
Prep technique
Chin-sternum-shoulder-neck-ear
Earlobe-> Chine-> sternum -> shoulder and to the bed
Drap technique
Head to foot; side to side
needle used to find vein
Vein Identification
Without ultrasound
25g “seeker needle”
now have catheter over needle
atrial caval junction on RIJ
15 cm
atrial caval junction for LIJ
18 cm
R Sub Clavian atrial caval junction
14 cm
L subclavian atrial caval junciton
17 cm
Placement confirmation via CXR
Catheter tip
No pneumothorax/hemothorax
No wire
where does the CL sit?
caval/ atrial junction. (where the vena cava and T atrium meet)
Anatomy for the IJ
Sternoclidomastoid mucle -> sternal and clavicular head = triangle
Find muscle and 2 heads. At apex of triangle = point at ispliateral (same side) nipple. And at that 45 degree angel at that direction = we hit an IJ.
