Central Lines & Arterial Lines Flashcards
What is the most commonly used vein for a central line?
Internal jugular vein
What are the 4 most commonly used veins for a central line?
1) Internal jugular vein
2) Subclavian vein
3) Femoral vein
4) Axillary vein
Give some reasons for a central line
1) TPN
2) Resus with fluid or blood
3) Irritant drugs - vasopressors, amiodarone
4) Monitoring of central venous pressure
Give some complications of CVC insertion
1) Failure
2) Arterial injury - puncture or accidental cannulation
3) Arrhythmia - guidewire irritates the myocardium
4) Pneumothorax (due to close proximity to apex)
5) Air embolism/entrainment
Give some reasons for inserting an arterial line
1) Beat to beat BP measurement: if need careful control of BP or rapid changes are possible
2) BP cuff causes injury e.g. long surgeries
3) Regular blood gas sampling
4) Accuracy of normal BP cuff may be impaired e.g. severe hypotension
What test should be performed prior to insertion of an arterial line?
Allen’s test
Briefly describe interpretation of an arterial line waveform
Max height of wave = systolic BP
Lowest point of wave = diastolic BP
Dichrotic notch marks the end of systole and beginning of diastole.
Give some complications of an arterial line
- Arterial thrombus
- Distal ischaemia
- Infection
- Bleeding - direct injury to vessel, disconnection
- Accidental drug injection