Central Line Pressure Monitoring (Nursing)

00:01 Our next invasive hemodynamic monitoring is our central venous pressure monitoring.

00:07 This is taken by putting a catheter in the internal jugular or subclavian vein and recording the pressure that's inside of there.

00:14 Now we're going to be using the brown port on that which is the most distal port, so we have the most accurate.

00:20 You want to get as close to the right atrium as possible.

00:23 You can take a pressure from the femoral artery, but this is farther away from the right atrium and may not be as accurate as the subclavian vein or the internal jugular.

00:35 From this we get the central venous pressure, which later in our series will discuss further.

00:43 I'm going to show you how to set up a pressure tubing to get ready for an arterial line or a central venous pressure line or a PA catheter line.

00:51 So I've got my normal saline here.

00:53 I've wrap my pressure bag.

00:55 You're going to need a transducer holder and your pressure tubing.

00:58 So first thing is to hang these up and get it ready to spike.

01:04 So, I'm going to put this in right here.

01:09 And then make sure I lock it, so that no saline is going everywhere.

01:14 Then I'm going to put the transducer into the transducer holder.

01:21 Just like that.

01:23 Now I'm going to prime it.

01:25 Okay, so as I open it...

01:38 I need to pull the pigtail in order for saline to come through.

01:42 Now most important is that I'm not priming it under pressure.

01:47 If you prime this under pressure, you will cause agitation to the saline and you're gonna get a bunch of micro bubbles that form in this tubing, and they're gonna get stuck and cause a damp and wave form.

02:00 Once I've got it primed, I'm gonna lock it off.

02:03 And then I'm going to turn the stopcock up so that no saline comes back out and then I'm ready to start.

02:10 The only other thing I need to do is grab this pressure bag and then we need to put this tubing under pressure.

02:23 So I'm going to grab this, guide it through it.

02:30 Just like that.

02:31 It's got a little hook on here.

02:34 That's going to hold it in there.

02:35 And then I'm going to pump this up to 300 mmHg.

02:41 Okay, so as I pump it's putting pressure into the system and on the bag.

02:54 Okay.

02:58 Now, this is going to rise up and get to 300 mmHg.

03:09 Okay, now I'm at 250 and then I'm in the green spot, which means I'm at 300 mmHg.

03:14 A lot of times a lot of nurses like to turn the stopcock up to prevent any air loss.

03:19 So now with this setup, I am ready to start transducing my arterial line, my central venous pressure line or my PA catheter.

03:28 Now one last piece of information.

03:30 In order to get this transducer to send a signal to your bedside monitor is you need to hook up a cable from this part into your bedside monitor and then make sure that the stopcock is at the phlebostatic axis.