Central lines Flashcards
What is a central line?
A large bore cannula or catheter inserted into one of the larger veins in the body in which the cannula tip may line in SVC, IVC or right atrium
What are some reasons for inserting a central line?
- Measurement of central venous pressure,
- Administration of drugs/products that would damage smaller veins, eg, chemo.
- Need to obtain venous access in patient who’s peripheral veins have shut down.
- Administer high flow fluids.
- Easy administration of products a patient is likely to need IV access for several days.
Where are the most common sites for central line insertion?
Internal jugular vein and subclavian vein
Where are the lesser common sites for central line insertion?
Femoral vein and external jugular vein.
Briefly describe the process of inserting a central line
Patient lies down and faces away from insertion. Most often can use ultrasound to guide needle into vein. A guide wire is then passed through the needle into the vein. After, the cannula or catheter is then passed over the guide wire into the vein and the wire can be removed.
Most central lines are multi-lumen. What does this mean and what does this allow for?
Mean is has multiple cannulae and connections, this allows for different fluids and drugs to be given at the same time whilst the CVP is measured.
What does a low and high CVP mean?
Low - Indicates venous return is lower than it should be (occurs in hypovolaemic shock or dehydration).
High - Indicates R sided heart failure which may be due to a number of reasons)
What are some common complications of central line insertions?
- Puncture of apex of lung leading to pneumothorax.
- Puncturing major vessel as well as lung leads to haemothorax.
- Cannulating a large artery.
- Damage to thoracic duct if insertion is on the left.
- Introducing air which can cause air embolism.
- Risk of infection into major blood vessel
- Damage to venous valves which may result in thrombus.
