Central Lines

N60B SKILLS LAB

SPRING 2015

Indications for Central Lines

No peripheral sites
Complex treatment
Infusion of vesicant drugs
Example: Chemo

Irritating Substances
Vancomycin, Dilantin
Rapid blood replacement
Hyperosmolar solutions

PPN = Osm = 1100

TPN=Osm = 1900-2300

Need for multiple lumens

Insertion

Sterile procedure
Primary RN assists
Stitched vs STAT LOCK
Chest X-ray
Complications

Single, Double and Triple Lumen

Lumens
Which lumen is largest?
Recommend:

distal lumen
Proximal
Medial lumen

Administer simultaneous or incompatible

infusions

Exit sites
Pigtails
Statlock

Groshong

Valves
Valve stays closed

CENTRAL
LINE
Subclavian vein
Tunnled
Double lumen

CENTRAL
LINE
Subclavian vein
Triple lumen
7 days
Dressing Change
Flushing
Blood Draw

PICC LINE
Inserted by PICC RN
1, 2 & 3 lumens
Ultrasound Guided
Dressing Change
Flushing
Blood Draw

Port-a-Cath
OP surgery Procedure
Single or double lumen
Access
Huber needle

Dressing Change
Flushing
Blood Draw

Dialysis
Catheter
Emergency/ temporary
vs. tunneled
2 ports Venous vs.
arterial
Dialysis RN: access
maintenance & care
Can be accessed in an
emergency. (Code Blue)

ASSESSMENT & DRESSING CHANGE

ASSESSMENT
Central line dressing kit
Bio Patch
Sterile procedure
Sterile gloves
Mask
Pt. Positioning

Administering Medications
Gather your supplies
10 ml syringes
Push Pause method
Positive pressure in last

0.2-0.5 ml