What am I?
What do we pull ABG's off of?
Arterial Line
I'm longer/thicker than a regular IV. I go further into the vein and I can stay in place for up to 3 months. What am I?
Peripherally inserted central catheter
What is the function/why do we use an ______ line?
Continuous arterial blood gas monitoring, invasive BP monitoring/ To monitor pt's closely who require vasoactive medications/ antihypertensives or are in low output shock states
Why do we use ____ line?
when medium/long term access is needed: tip lies just outside atrium through Superior VC, preferred for med admin over peripheral IV's or IO (inserted in upper arms, but unlike CVC not placed in neck/groin)
long term IV Abx, chemotherapy, medication administration, nutrition line
Why do we use this as CCP's?
Many of our pt's are unstable due to shock states and require continuous IBP monitoring (especially giving vasoactive meds/fluids, etc) and ABG's need to be monitored to see efficacy of ventilator settings and other treatments
Uses of ____ line as CCP's?
Medication administration primarily
Typically CCP's will not be running chemo drugs or parenteral nutrition
It is very uncommon for VBGs to be taken from these lines as it can damage the line from suction/vacuum seal
Common transport issues
dislodged line/hemorrhage
Clotting from inadequate blood flow/ enough pressure from fluids/ Absence of waveform
Dampening of waveform (over/under)
Abnormal readings, Air bubbles?
Common transport issues?
PICC lines can clot easily (sluggish infusions), line can be pulled out/ kinked/tangled, catheter can become damaged
Trouble shooting- dislodged line/hemorrhage? Clotting from inadequate blood flow? Absence of waveform? Dampening of waveform? Abnormal readings? Air bubbles?
-hold direct pressure, do not try to replace, if no blood is aspirated the catheter may need to be removed. -ensure pressure bag is properly inflated - flush line w/ fast flush for 1-2sec - pressure infuser inflated, look for loose connections, air bubbles or kinks - check transducer in line w/ phlebostatic axis, re-zero - slowly fill circuit w/ fluid, stopcocks closed to air, aspirate blood to stopcock then slowly flush w/ fluid
Trouble shooting! Slow infusion? Clot? Catheter damage?
PICC lines require regular flushing when not in use to avoid clotting, low dose warfarin can be added to pt's daily medications if previous clotting issues, check line for kinks/damage often, check insertion site
if catheter damaged on the outside clamp between damaged area and skin, do not attempt to remove