Lines Flashcards
Peripheral lines
Enter into circulation through any peripheral vessels
Arterial line
Brachial, radial, or femoral artery
-placed by MD
Monitoring arterial BP via display, access for ABG, labs
In ICU cannot be hep locked.
Transducer placed @ level of left atrium when taking a reading.
If femoral Aline discontinued, may be on bed rest 60-90 mins.
Transducer should be moved to shoulder level and given a second to calibrate
If below the heart, elevated pressure, above the heart, decreased pressure
If A line comes out
Apply pressure w/ anything you can
THEN
Call the nurse
Intravenous line
Any accessible vein; placed by RN, duration 3 days
Administrate drugs/fluid, blood transfusion, obtaining venous blood, cannot be used to draw blood
Can usually be heplocked. Free to move around w/ IV pole
Central lines
Catheter that is treated through the internal jugular vein, ante cubital vein, basilic or subclavian vein w/ tip usually resting in the superior vena cava or right atrium.
Central venous catheter
Placed by MD, duration 2-3 weeks
Monitoring central venous pressures, administer drugs, fluids, transfusion; total pareneral nutrition
No ROM > 90 shoulder or hip
No horizontal ADD
Do not take BP on side of lines
Swan-Ganz catheter
PA line or pulmonary artery line
Subclavian jugular vein to pulmonary artery
Placed by MD
Monitoring heart pressures, CO, core temp, pulm activity
No ROM > 90 at shoulder
No horizontal ADD
Avoid heat/neck movements (for subclavian)
Cannot be hepblocked
Peripherally inserted central catheter (PICC)
Basilic (most common), cephalon or median cubital vein to superior vena cava or inferior vena cava
Access for long term admin of TPN, meds, fluids, blood products or chemotherapy
No BP on involved extreme it’s
Intracranial pressure monitoring
Maintenance of normal cerebral perfusion pressure and early ID of increased ICP
Keep head of bed at 30 degrees
Normal ICP
4-15
What will increase ICP
- lowering head of bed
- lateral neck flexion/extreme hip flexion
- valsalva
- noxious stim
- pain
- stress
- coughing
- frequent arousal from sleep
ICP levels
15-20 cause for concern
>20 clearly abnormal
20-40 moderate HTN
>40 severe, life threatening intercranial HTN
ICP bolt or subarachnoid bolt
Subarachnoid space via burr hold
Placed by MD
Short term use if cerebral edema prevents use of other devices
Rare will PT get this pt into upright position- no OOB -change head of bed but monitor ICP ROM (passive) + education Ther-ex stretches Position changes, positioning, education Rolling/bed mobility
Ventriculostomy
Intraventricular catheter
Anterior horn of lateral ventricle via burr hole;
Placed by MD
Drainage or sampling of CSF; monitor ICP
Need to look for color changes
Notify nurse
Ventriculostomy
-gold standard for ICP measure
-Foramen of monro-new one set or worsening of HA,
Set up in reference to ear. If open fluid still draining off, set up must remain where dr wants it to be, no tighter or lower. Let nurse know if you’ve changed the set up
-Open vs closed
ask person/place/time/situation - assess mental status-awareness and level of consciousness
-Signs of increased ICP
