Central Line Placement and CVP Flashcards Preview

I & M 441 > Central Line Placement and CVP > Flashcards

Flashcards in Central Line Placement and CVP Deck (18)
Loading flashcards...

Where is CVP located? And what’s its normal value according to the lecture?  

in the vena cava at the junction with the right atrium. It’s normal value is 10 (8~12)mmHg


The CVP reflects ___(left/right?) heart function and is not a reliable indicator of ___(left/right?) ventricular performance. 

Right; Left


If ____decreases, the CVP decreases. 

right side preload


Know where all the waves and descents are on the graph


What are some common insertion sites for central line

Internal jugular: left or right; Sublcavian; Femoral; Brachial


What’s the proper way to prep for CVP with cholrhexidine?

Use back and force motion for 30sec for dry area and 2min for moist area


What are some factors that can affect CVP? 

cardiac performance, blood volume, vascular tone, increased intra-abdominal or intrathoracic pressures and vasopressor therapy


What does A wave indicate and where does it correspond to EKG? 

atrial contraction; Occurs right after P wave on the ECG 


What would cause A wave to increase? 

Tricuspid Stenosis; RVH; Pulmonary Stenosis; Pulmonary Hypertension; Giant A Waves-Cannon: AV block-RA contracts against a closed tricuspid valve 


What does C wave indicate and where does it correspond to EKG? 

Caused by elevation of tricuspid valve into the right atrium during early ventricular/systolic contraction; Corresponds to the end of the QRS on the ECG 


What does X descent indicate and where does it correspond to EKG? 

 The X descent results from an atrial relaxation and downward displacement of the tricuspid valve during ventricular systole. Occurs during ST segment on the EKG 


When would X descent disappear? 

in tricuspid regurgitation


 What does V wave indicate and where does it correspond to EKG

Caused by pressure produced when the blood filling the right atrium hits against a closed tricuspid valve; Corresponds to the end of the T wave on the ECG 


What happens to V wave in Tricuspid Regurgitation?

Prominent V waves


What does Y descent indicate and where does it correspond to EKG

Produced by blood flowing into the right ventricle through an open tricuspid valve; Occurs before the P wave (prior to atrial contraction) on the ECG 


Indications for CVP? 

To monitor pre-load; Hypovolemia ; Shock; Aspiration of Air Emboli; TPN; Insertion of transcutaneous pacing leads; IV access in patients with poor peripheral veins; Infusion of vasoactive medications 


Contraindications for CVP? 

Tumors in the right atrium; Severe Coagulopathy; Ipsilateral carotid endarterectomy


Complications can be caused by central line placement

Pneumothorax; Carotid Artery Puncture; Hemothorax from Vascular rupture; Air Embolism, wire embolization, thrombosis; Cardiac Perforation; Hematoma; Cardiac Tamponade; Arrhytmias, Hydrothorax, Chylothorax; Infection