Assisting Central Venous Catheter (CVC) Insertion (Procedure1)
Assisting Central Venous Catheter (CVC) Insertion (Procedure1)
Assisting Central Venous Catheter (CVC) Insertion (Procedure1)
Introduction:
A central venous access catheter, also known as a central line, is a sterile catheter inserted in
a large vein as (internal jugular, subclavian, and femoral). These long, flexible catheters
empty out in or near the heart, allowing the catheter to give the needed treatment within
seconds.
Purposes of insertion:
Volume resuscitation
Nutritional support
Administration of emergency medications ( vasopressors)
Central venous pressure monitoring
Hemodialysis
Contraindications to CVC:
Local infection
Distorted local anatomy
Coagulopathy
Previous radiation therapy
Suspected proximal vascular injury
Traumatized site (eg. clavicle fracture and subclavian line)
Burned site
Equipment:
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2. Ancillary equipment for CVC
Oxygen supply
Pulse oximeter and Blood pressure cuff
Crash cart with cardiac monitor
Immediate
Pneumothorax
Haemothorax
Arterial puncture
Local haematoma
Guidewire-induced arrhythmia
Air embolism
Late
Vascular erosion
vessel stenosis
Thrombosis
Remember to:
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Assisting Central Venous Catheter (CVC) Insertion Procedure
# Steps Rational
Pre procedure:
1. Wash hands To minimize infection
2. Prepare equipment To save time
3. Introduce youreslf to patient To build trust
4. Identfiy the patient To ensure that is the right patient
5. Explain procedure to the patient The patient may be very anxious and it is important
that the nurse gives a clear explanation and
reassurance before, during and after the procedure.
6. Keep patient privacy To minimize embarrassment
7. Put patient in correct position To encourage venous engorgement, which makes it
The patient should lie supine and the head easier to puncture the vein and reduce the risk of air
of the bed should be lowered embolism
Trendelenburg position(10-15) in case of
internal jugular and subclavian CVL
15 To facilitate insertion.
Turn or instruct patient to turn head away
from insertion site.
16 Explain what is happening throughout the To ensure patient comfort during the procedure.
procedure While the physician disinfecting
the area.
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17 To prevent infection transmission to the insertion site
Perpare a sterile field on the bed side
table and Make sure to have some spare
gauze swabs ready.
20 Ensure that physacian drapes the patient To sterile field and to comply with maximal barrier
with large sterile drapes percaution.
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2 To prevent complication during insertion
Monitor heart rate & rhythm,
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respiratory rate & patient response
throughout the procedure. observe
cardiac monitor closely as guidewire
& catheter are inserted & notify
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physician immediately if dysrhythmia
occurs.
2 Label the dressing with data , the time To ensure proper identification and documentation.
5 and your intials of physicain.
2 Mak sure that all lumen clamps are closed To prevent air embolism
6
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2 Intiate IV therapy if perscribed after an X
8 rays comfirms correct placement in the
superior vena cava
2 Reasses patient patient after 30 mins To assess any signs of insertion related commplication
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Post procedure:
3 Dispose any used material To reduce infection
0
3 Remove gloves To reduce infection
1
3 Wash hands To reduce infection
2
3 Record the procedure Documentation provides ongoing data
3
3 Report any abnormalitis such as sudden To ensure patient safety
4 dyspnea, pallor, tachycardia.
Reference:
- Delves-Yates, C. ed., 2018. Essentials of nursing practice. Sage.
- Lynn, P., 2018. Skill Checklists for Taylor's Clinical Nursing Skills. Lippincott Williams
& Wilkins.
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