Lines for monitoring Flashcards
Arterial Line
a special type of cannula inserted into an artery (e.g., the radial artery). The blood pressure can be accurately monitored in real-time using an arterial line. Arterial blood samples (for ABG monitoring) can be taken from the line. Medications are never given through an arterial line.
central line ‘central venous catheter’
long thin tube with several lumens (usually 3-5) that is inserted into a large vein, with the tip located in the vena cava. They may be inserted into the Internal jugular vein,
Subclavian vein or
Femoral vein
they have separate lumens (tubes) which can be used for giving meds / taking blood samples. more reliable and last longer than peripheral cannnulas. can also be used to deliver meds that would be too irritating to give through peripheral cannula (inotropes, amiadorone, fluids high in k+)
Vas Cath
*a type of central venous catheter
inserted on a temp basis usually in the internal jugular vein or the femoral vein. has 2-3 lumens. can be used for short term haemodialysis in renal failure
PICC line
a type of central venous catheter. Aa ong, thin tube is inserted into a peripheral vein (e.g., in the arm) and fed through the venous system until the tip is in a central vein (the vena cava or right atrium).
They contain one or two lumens that are a narrower diameter than a standard central line. They have a low risk of infection, meaning they can stay in for a prolonged period and are useful as medium-term IV access.
types of central venous catheters
(aka central line)
- vas cath (temp basis with 2-3 lumens)
- PIIC line (into a peripheral vein)
- tunnelled central venous catheter i.e hickman line
Hickman line (tunelled central venous catheter)
A Hickman line is a type of tunnelled central venous catheter. It is a long, thin catheter that enters the skin on the chest, travels through the subcutaneous tissue (“tunnelled”), then enters into the subclavian or jugular vein, with a tip that sits in the superior vena cava.
There is a cuff (sleeve) that surrounds the catheter near the skin insertion. It promotes adhesion of tissue to the cuff, making the catheter more permanent and providing a barrier to bacterial infection. They can stay in longer-term and be used for regular IV treatment (e.g., chemotherapy or haemodialysis).
‘Swan-Ganz catheter’ pulmonary artery catheter
A pulmonary artery catheter is inserted into the internal jugular vein, through the central venous system, right atrium, right ventricle and into a pulmonary artery.
It has a balloon on the end that can be inflated to “wedge” the catheter in a branch of the pulmonary artery.
The pressure distal to the wedged balloon can be measured. This gives the pulmonary artery wedge pressure, which gives an indication of the pressures in the left atrium. This is rarely used, mostly used in specialist cardiac centres for close monitoring of cardiac function and response to treatment.
Portacath
a type of central venous catheter
There is a small chamber (port) under the skin at the top of the chest that is used to access the device. This chamber is connected to a catheter that travels through the subcutaneous tissue and into the subclavian vein, with a tip that sits in the superior vena cava or right atrium.
When nothing is attached to the port, the skin remains intact, and there are no lines outside the body. The port can be seen as a bump on the chest wall and felt through the skin (similar to palpitating a pacemaker). When the catheter needs to be accessed, a needle is inserted through the skin into the port, allowing injections to be given or infusions to be set up.
They are fully internalised under the skin, reducing the chance of infection, meaning they last the longest of the options for central venous access. Only specially trained staff are able to access a Portacath. They remain long-term and can be used for regular IV treatment (e.g., chemotherapy).
