Central line principles - Exam 3

Question 1

What are 4 options for CVC placement?

Answer 1

EJ, IJ, Subclavian, Femoral

Question 2

Indications for CVC

Answer 2

-CVP
-Caustic drugs
-TPN
-Air emboli aspiration
-Transcutaneous pacing
-Venous access in ppl with terrible veins
-HD access

Question 3

Contraindications for CVC

Answer 3

-renal cell tumor extending into RA
-Tricuspid valve vegetation
-Site infection
-Site specific contradincations (putting fem in a patient who is having crazy diarrhea)

Question 4

Complications of CVC

Answer 4

-Pneumo/Hemo
-Line related infection
-Carotid puncture
-Dysrhythmias
-trauma to nearby nerves

Question 5

Anatomy CVC pic

Answer 5

Between sternocleicomastoid and anterior scalene muscles

Question 6

Why do we trendelenberg pt for CVC insertion

Answer 6

Decrease risk of air emboli
Increase venous return

Question 7

Prep technique for CVC

Answer 7

Chin
Sternum
Shoulder
Neck
Ear

Question 8

Drape technique for CVC

Answer 8

Head to foot
Side to side

Question 9

Pic of in plane vs out of plane

Answer 9

Question 10

If i want to find a vein for CVC without ultrasound, what kinda needle should i use?

Answer 10

25 g seeker needle

then thread catheter over seeker needle

Question 11

Steps of CVC insertion using ultrasound

Answer 11

-ID vein with US
-Use an introducer needle (such as a herken needle)
-Insert J wire through needle or catheter
-Remove needle
-Nick skin to enlarge opening
-Advance catheter over wire (never letting go of J wire) in a twisting motion
- remove j wire and cap catheter

Question 12

Catheter distance:

R subclavian
R IJ
L Subclavian
L IJ

Answer 12

14
15
17
18

Question 13

What 3 things am i looking for on cxray after CVC placement

Answer 13

-Catheter tip
-Look for pneumo/hemothorax
-No wire left in pt