Central Venous & Pulmonary Catheters Flashcards
How do PICC line and central lines differ in length?
PICC lines are 60cm long and central venous catheters have 16-40cm in length.
What sites can a central venous catheter be inserted?
- subclavian vein
- internal jugular
- femoral vein
- antecubital fossa
Which site is associated with the lowest rate of infection?
Subclavian line
What are the complications of CVC insertion? (6)
- Arrhythmia (SVT/ VT)
- Arterial puncture
- Pneumothorax
- Air embolism
- Nerve injury
- Bleeding
Which nerves are at risk of injury in the neck area?
Phrenic nerve, brachial plexus nerves, recurrent laryngeal nerves, sympathetic nerve and hypoglossal nerve
What are late complications of CVC?
- Cardiac tamponade - due to puncture of atrium by catheter
- Thrombosis - 8% risk in internal jugular, 20% in femoral veins
- Infection
What preparation solution is best for reducing risk of line infection?
2% chlorhexidine in 70% isopropyl alcohol skin prep and anti microbial coated lines
What are the indications for pulmonary artery flotation catheters?
- Monitoring of high risk patient
2. Management of LV dysfunction
Where does pulmonary artery flotation catheter sit?
Floats with circulation into right atrium, right ventricle and pulmonary outflow tract and occludes one of the major pulmonary vessels.
Provides occlusion pressure
Is the pulmonary artery occlusion pressure (PAOP) always higher or lower than the mean pulmonary artery pressure (PAP)?
PAOP < PAP
Pressure waveform should always return to PAP when balloon is deflated.
What is the pulmonary artery floating catheter pressures at these positions?
- Right atrial pressure
- Right ventricular: sys/ dia
- Pulmonary artery: s/d
- Pulmonary artery occlusion pressure
- R atrial: 0-5 mm Hg
- R vent: 20-30 / 0-5 mm Hg
- PAP: 20-30 / 10-20 mm Hg
- PAOP: 6-12 mm Hg
