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Flashcards in lab Deck (30):
1

advantage of internal jugular Central venous cath

bleeding can be recognized and controlled, malposition is rare and there is less risk of pneumothorax

2

disadvantage of internal jugular central venous cath

risk of carotid a. puncture and PTX is possible

3

advantage of femoral central venous cath

it is easy to find, there is no risk of PTX, there are fewer bad complications

4

Disadvantage of femoral central venous cath

this has the highest risk of infection, there is risk of DVT and is not ideal in patients who are ambulatory

5

Preferred Central Venous cath site for emergencies and CPR

Femoral V

6

advantage of subclavian central venous cath

this is the site that is most comfortable for conscious patients

7

Disadvantage of subclavian central venous cath

highest risk of PTX and the vein is not compressible

8

Contraindications for subclavian central venous cath

if pt is incubated or

9

Approach for subclavian central venous cath

aim towards the supraclavicular notch just under the right clavicle. Needle should be parallel to skin

10

approach for internal jugular central venous cath

Stand at the head of the bed and on the right side, find space where SCM meets the clavicle. Locate the carotid aa, angle needle 30-40 degrees and lateral to the carotid aa. Aim towards the ipsilateral nipple under the SCM.

11

approach for the femoral central venous cath

find femoral pulse, and go down 2 cm below the inguinal ligament. At a 45 degree angle aim towards the umbilicus, just medial to the femoral aa

12

indications for central venous cath

CVP monitoring, volume resuscitation, cardiac arrest, lack of peripheral access

13

contraindications for central venous cath

cellulitis, burns, severe dermatitis at site. Relatively few CIs.

14

if doing central venous cath in pt with PTX

use the vein on the same side as the PTX

15

indications for arterial line

Continuous BP monitoring, frequent ABG

16

arterial cannula size for adults

20 G

17

arterial cannula size for peds

22 G

18

arterial cannula size for neonates

24 G

19

arterial line saline

pressurized to 300mmHg, + 2500 U heparin, continuous flow 3-4 mL/hr

20

Reasons to not allow arterial saline bag to empty

to maintain patency of cannula, to prevent air embolism, to maintain accurate BP reading, and prevent back flow of blood

21

drugs that can be injected in arterial line

NONE. DO NOT INJECT DRUGS IN ARTERIAL LINE

22

site most common for arterial line placement

radial a.

23

arterial waveforms- highest notch

indicates systolic pressure

24

arterial waveform lowest notch

indicated diastolic pressure

25

arterial waveform dicrotic notche

when aortic valve closes

26

SBP of arterial line is ___ compared to non invasive BP

5 mmHg HIGHER

27

DBP of arterial line is ___ compared to non invasive BP

8 mmHg LOWER

28

unable to draw blood from an a-line but there is good tracing

the artery has most likely gone into spasm, d/t hypothermia, pressor meds, dehydration

29

after a-line placement

continually assess for color, sensation, motion and cap refill

30

a-line removal

whether intentional or not, will want to manually compress for 3-5 minutes, place compression dressing for 60 minutes, and check site hourly for a few hours afterwards to check for hematoma formation