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.