CVC
CVC Steps
- Laid out in order of use (image 5, bottomw middle)
- Consider pre-scanning the patient prior to sterilizing. Especially in vasculo-pathic patients.
- Drape the patient
- Get u/s sterilely
- Possibly numb if awake
- Place U/s probe looking for target vessel
- Switch the needle from blue syringe to otherwise with bevel lines with numbers and seal broken. Bounce over vessel before breaking skin to improve midline insertion. Advance needle until aspiration of Heme. Lower angle
- Remove syringe, advance wire feeling for resistance and listening for EKG changes
- Approx 20-30 cm, remove needle , leaving behind the wire
- U/s to confirm in vein. Knick the skin
- Pull traction on mandible, place line/dilator combo over the wire. Should feel two pops. About half way down, advance the catheter and remove dilator and wire.
- Yell wire out
- Suture in. CHG dressing
- Final image has other tools that com in a kit. Yellow/clear is known as the “swandom”. This is used when placing a Swan Catheter. The one next to it can be used for manomentry if conern about arterial vs venous puncture. Other options to help confirm is U/S is unclear, ABG and connect to a pressure bag.
Hot Line for Blood Tubing
Connecting the holine from image number two:
Connect the Filter part (red) to the hotline fluid warming set. THen connect the fluid warming set to the extension. Most people will place one stopcock between each connection.
Turn off the roller clamps. Spike the NS. Open the clamp close to the NS bag and fill the first chamber. Turn the chamber without the filter upside down and release the distal clamp. Drop the line once chamber is full to prime the rest
More to come:
– aline
– DLT