Central lines + CLABSI Bundle

Define Central Venous Pressure (CVP)

• CVP is the blood pressure in the vena cava, near the right atrium of the heart. 

Explain the indications for CVC placement

• administer intravenous fluids and blood products
• administer medications
• administer hypertonic solution (TPN) (chemotherapy)
• blood sampling
• monitor CVP

What are the common CVC insertion sites?

• jugular vein/ subclavian vein
• brachial, cephalic, basili vein
• femoral vein

What are some complications associated with CVCs?

• subcutaneous emphysema
• air embolism
• hematoma
• infection, thrombosis
• pneumothorax
• bleeding

What is the normal CVP range in adults and pediatrics?

• 5~10cm H2O,  

Describe factors that can increase and decrease the CVP?

• increase: decreased cardiac output, increased blood volume, venous constriction, arterial dilatation
• decrease: hypovolemia, decreased venous return, excessive veno or vasodilation, shock

How will you interpret CVP waveforms? (Describe the 5 waves)

What is CLABSI- what does it stand for? Explain how you will prevent CLABSI in your unit. ( answer using the CLABSI Bundle)

 

CLABSI stands for central line associated bloodstream infection. 

Prevent CLABSI: 

• hand hygiene
• maintain 4 barrier techniques
• skin antisepsis with chlorhexidine (every time when you inject medication)
• avoiding femoral access
• removal of needless CVC