Final Blueprint Lines/Hemodynamics Flashcards
what is important to know when working with a central line?
Flush and check for blood return
NOT when line is being used for things like vasoactive meds (DO NOT want to accidentally bolus the patient w/ vasopressor)
When blood is drawn from line, flush with 10cc using push/pause method to prevent fibrin clots from forming at the tip of the cath
ONLY use 10mL syringe so that the pressure difference doesn’t cause cath to rupture
Do not use central line to draw blood cultures
Use peripheral sticks to eliminate possibility of getting a false positive CLABSI
Line care: minimize access, use ceros caps, scrub the hub (15 seconds and 15 seconds dry), and change caps after blood draw to prevent clot formation).
what is important about the assessment of a central line dressing?
Dressing should always be clean, dry, intact
If the dressing is not pristine, then it needs to be changes
Standard dressing change every 7 days and PRN
Gauze underneath (change every 24h
Sterile procedure (everyone in the room is masked including the fam members)
Use bio patch (blue side up, impregnanted with CHG)
what is the assessment for an arterial line?
Need for real-time, accurate BP monitoring and MAP
Critical illness, vasoactive meds, hemorrhage, high risk procedures
Inability to use non-invasive monitoring (bariatric burns)
Frequent ABG’s
Only used for monitoring and ABG’s, NO MEDS
Assess often for signs of infection
Keep transducer at phlebostatic axis (level with the atria —> heart level)
Zero transducer with position changes
STRICT adherence to policies
Arterial catheter - artery = measure of pressure inside artery
Accurate readings of SBP, DBP, MAP
Non-invasive BP is not needed and is placed on the same are of art line, will flatten the waveform while inflated
Blood draws: when frequent draws are needed (ABGs)
what is the arterial line set up?
Placement: radial, brachial, femoral
Mismanagement of transducer will give inaccurate readings and dampened waveforms
what is important to know about central line safety?
Biggest risk = air embolism from removal. Risk = bleeding (coagulation disorders and puncture of vessel), pneumo/hemothorax (accidental puncture of lung during insertion of subclavian), and mispositioned (accidental arterial cannulation rather than venous: IJ and femoral most common, use U/S guidance to prevent, CXR confirm b4 use, and observe color of blood from line).
