Central Lines Flashcards
MC complication of subclavian central line
pneumothorax
MC complication of IJ central line
neck hematoma
MC complication of femoral line
Bleeding- manage with 10-15min direct pressure
Also, much higher risk of infection
Which central lines can utilized ultra sound guidance?
Internal Jugular
Femoral
Contraindications to femoral central line placement
known/suspected intra-abdominal hemorrhage
injury to pelvis, groin, iliac vessels, or IVC
difficult to palpate pulses in CPR
If following an unsuccessful subclavian attempt, use _____ side for IJ approach
same
contraindications to internal jugular central line placement
cervical trauma w/swelling or anatomy distortion
limited neck motion, cervical collar
carotid artery disease
contraindications to subclavian central line placement
history surgery/trauma to clavicle, 1st rib, subclavian vessel
Significant chest wall deformities
-can use other side if no injury to subclavian on this side
Significant cachexia or obesity
Contralateral pneumothorax
If transvenous pacemaker or pulmonary artery catheter is anticipated use eigher
left subclavian or right IJ
these sites align with SVC & RA
For femoral insertion, if no pulse is palpated
divide distance from ASIS to symphysis pubis into thirds – artery lies at junction of medial and middle thirds and the vein is 1 cm medial to this
locations for IO entry
medial flat proximal tibia
medial malleolus, distal femur, sternum, humerus, ileum
complications of IO use
cellutlits, osteomyelitis, iatrogenic fx or physeal plate injry, fat embolism
long term indwelling vascular devices include
cuffed tunneled right atrial catheters
implantable ports
mainstay of tx for long term CA therapy is
totally implantable vascular devide
Tunneled RA cath with SQ portal
Temporary Dialysis Catheters include
Quinton Mahurkar Tessio Vascath Hohn- place subclav, usually double lumen
