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Flashcards in Central Line Placement and CVP Deck (18)
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1

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

2

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

Right; Left

3

If ____decreases, the CVP decreases. 

right side preload

4

Know where all the waves and descents are on the graph

5

What are some common insertion sites for central line

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

6

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

7

What are some factors that can affect CVP? 

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

8

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

atrial contraction; Occurs right after P wave on the ECG 

9

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 

10

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 

11

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 

12

When would X descent disappear? 

in tricuspid regurgitation

13

 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 

14

What happens to V wave in Tricuspid Regurgitation?

Prominent V waves

15

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 

16

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 

17

Contraindications for CVP? 

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

18

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