cvp

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CENTRAL VENOUS PRESSURE

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- pressure within the right atrium or in the great veins within the thorax.- CVP monitoring serves as a guide for assessment of right-sided cardiac function and for left-sided cardiac function ONLY in the absence of Cardiorespiratory disease.


Purposes:

1. Serves as a guide for fluid replacement in seriously ill patients.2. Estimate blood volume deficits.3. Determine pressures in the right atrium and ventral veins.4. Evaluate for circulatory failure.


Most commonly used Vein sites for Catheter Placement:

• Subclavian• Internal or External jugular• Median basilic


Venous pressure trayCut down trayInfusion solution and infusion set3 to 4 way stopcock (a pressure transducer may be used)IV pole attached to bed; arm board; adhesive tapeECG monitorCarpenter’s level (for establishing zero point)

EQUIPMENT


Preparatory Phase

1. Assemble equipment.2. Explain the procedure.

3. Position patient comfortably in bed.

4. Attach manometer to IV pole. The zero point of the manometer should be

on a level with he patient’s right atrium


*mark mid-axillary line> CVP catheter is connected to 3 way stopcock that communicates to an open IV and manometer.> Start IV flow and fill manometer 10cm. Turn the stopcock and fill tubing with fluid.> CVP site is surgically cleansed.


> When catheter enters thorax, inspiratory fall and expiratory rise in venous pressure are observed.> ECG may monitor the patient during catheter insertion.> Catheter may be sutured or tape in place. Sterile dressing is applied.


MEASURING CVP

1. Place patient in an identifiable position and confirm the zero point. Intravascular pressures are measured to atmospheric pressure at the middle of right atrium.2. Position zero point of manometer at the level of the right atrium.3. Turn stopcock so the IV solution flows into the manometer, filling to about the 20-25cm level. Then turn stopcock so that solution in manometer flows into patient.


4. Observe fail in the height of the column of fluid in manometer. Record level at which solution stabilizes or stops moving downward. This is the CVP. Record CVP and the position of the patient.5. The CVP may range from 5-12cm water.6. Assess the patient’s clinical condition.7. Turn stopcock again to allow IV solution to flow from solution bottle into the patient’s vain.


A CVP line is a potential source of

SEPTICEMIA.


-che

THANK YOU!

cvp

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