N60B SKILLS LABSPRING 2015

Central Lines

Indications for Central LinesNo peripheral sitesComplex treatmentInfusion of vesicant drugsExample: ChemoIrritating SubstancesVancomycin, DilantinRapid blood replacement Hyperosmolar solutionsPPN = Osm = 1100TPN=Osm = 1900-2300Need for multiple lumens

InsertionSterile procedurePrimary RN assistsStitched vs STAT LOCKChest X-rayComplications

Single, Double and Triple Lumen

LumensWhich lumen is largest?Recommend: distal lumen Proximal Medial lumen Administer simultaneous or incompatible infusions

Exit sitesPigtailsStatlock

GroshongValves

Valve stays closed

CENTRAL LINE

Subclavian veinTunnled Double lumen

CENTRAL LINE

Subclavian veinTriple lumen7 daysDressing ChangeFlushingBlood Draw

PICC LINE

Inserted by PICC RN1, 2 & 3 lumensUltrasound GuidedDressing ChangeFlushingBlood Draw

Port-a-Cath OP surgery ProcedureSingle or double lumenAccessHuber needleDressing ChangeFlushing Blood Draw

Dialysis CatheterEmergency/ temporary vs. tunneled2 ports Venous vs. arterialDialysis RN: access maintenance & careCan be accessed in an emergency. (Code Blue)

ASSESSMENT & DRESSING CHANGEASSESSMENTCentral line dressing kitBio PatchSterile procedureSterile glovesMaskPt. Positioning

Administering MedicationsGather your supplies10 ml syringesPush Pause methodPositive pressure in last 0.2-0.5 ml

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