Central Lines Flashcards
What is another name for this?
Central venous catheter
Where is it usually done? - 3
Internal Jugular
Subclavian
Femoral
What does it allow clinicians to do? - 3
Administration of drugs and fluids
Withdrawal of venous blood samples
Measurement of venous pressure
Line placement:
What should be used to guide it?
USS although it can be done using anatomical landmarks
Which site of insertion is most popular in non-emergency situations?
Internal jugular
Internal jugular:
- Which one is used and why?
- The patient is positioned slightly head down. Why is this?
- What is used to check positioning once done?
Right jugular vein:
- A direct route to the heart
- Less chance of displacement
Avoids air embolism and fills the vein which improves the chances of success
CXR
Which site of insertion is used in an emergency?
Femoral vein
Indications:
Why may drugs need to be administered via this route?
What long term IV drugs can be given via this route? - 3
Why may it be needed if someone is severely dehydrated?
They may risk phlebitis or toxicity from extravasation (e.g. vasopressors, chemo, parenteral nutrition, potassium)
Chemo
Antibiotics
Parenteral nutrition
There will be inadequate peripheral venous access
Contraindications:
What pathology of the skin at the insertion site is an absolute CI?
Infection of the skin - cellulitis
Complications:
What is an obvious complication whenever anything is inserted into the body?
What can happen if you puncture the artery?
What type of embolism can form?
What can form between the artery and the vein?
What is a potential lung complication with internal jugular insertions?
What can happen to the heart due to guidewire or catheter stimulation of the right side of the heart?
Bloodstream infection - bacteraemia
Bleeding
Haematoma
Air embolism
AV fistula
Pneumothorax
Haemothorax
Chylothorax
Arrhythmias
Tunnelled line:
Why is it called tunnelled?
Where does the line end up?
Hickman catheter (dual lumen) - what is this used for?
Brovaic catheter (single-lumen) - what is this used for? - 2
A line which is tunnelled under the chest wall ‘exit site’, where it can be accessed, to an ‘entrance site’, typically the IJV.
Ends up in the SVC
Chemo
Antibiotics or parenteral nutrition
PICC line:
What does this stand for?
Why are they a good alternative for central lines?
Where is it done?
Peripheral-inserted central catheter
Can be in situ for 6 months
The brachial or basilic vein then threading the line into the subclavian vein or SVA
