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Central Lines CVC-Central Venous Catheters
The placement of a catheter in the right superior vena cava via the cephalic or basilic veins.
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Purpose of Central Lines
Poor peripheral venous access Administer large volumes & multiple IVF’s Central lines may have 1-4 ports Administration of “caustic” meds Long term administration Diagnostic/blood sampling TPN solutions
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Anatomy of a Central Line
Usually made of silicone Has 1-4 ports with male adaptors “Surgically” inserted by MD Sutured into the skin to prevent dislodgement Covered with sterile dressing
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Nursing Responsibilities
Verify patient’s consent/allergies Secure supplies-can be bedside Prepare IVF per MD orders or heparin flush Wash insertion site prior to insertion Patient education
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CVC Maintenance/Care Know facility policy CVC dressing change
Assess for redness, warmth, edema, drainage Use transparent dressing CVC site care Do not touch insertion site Use CVC dressing kit if available
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Flushing CVC line Essential in maintaining patency
Never use a syringe with < 10 mL-creates to much pressure Saline mL Heparin (100units/mL) 5 mL-have patient perform Valsalva manuever (prevents occulsion of line) Change male adaptors per policy
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CVC Line Occlusion Line won’t flush-STOP Notify MD
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Removal of CVC Line RN can remove CVC line
Review procedure per facility policy Position patient in Trendelenberg or flat Hand hygiene Remove dressing/sutures Valsalva maneuver (prevents air embolism) Pull with smooth steady motion
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Post CVC Line Removal Assess site Pressure dressing Assess CVC cath
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Complications of CVC Lines
Sepsis Thrombus formation Air embolism
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