CVP Line Question - page 2

Hi! Need some assistance here...How do you position a patient 24hrs post-op whose CVP line was accidentally disconnected. Patient is in respi distress and hypotensive. Please help!... Read More

  1. by   nedanurse
    just to throw 2 cents in. I do know that the CVp and Pa pressures are more accurate when the pt is in bed laying down and the pt is zero'd.
  2. by   dfk
    Quote from tde1992
    This person said that when a person has a CVP their head of bed can't be elevated. I have never heard of that, I am going to try to find literature regarding this. I work in a medical intesive care unit, where we monitor CVP all the time via central lines, and swans, but I have never heard of any contrandications with finding the values with the head of bed raised. I do know that the actual values should be read during expiration due to the increased intrathoracic pressure which increases the readings. Can anyone comment on the head of bed issue and monitor of CVP. Thanks
    you're correct in what you are saying, but if i remember, the OP was relating question about air bubble and best position for pt to NOT get embolus.
  3. by   nedanurse
    thats cool. At least I was right about something. There are days I dont feel like that will ever happen again. Well thanks for the info. i get to admitt a double lung tx today. Good for me

    HAVE A GREAT DAYS FELLOW NURSES I LOVE MY JOB AND MY PROFESSION
  4. by   TopherSRN
    Read a published source today that said the differences in readings are minimal when the HOB angle is 0-60 degrees. Higher than that and accuracy declines. I rarely keep a patient flat, for obvious reasons. I am also not as concerned with any actual number, rather the trends of said numbers.
  5. by   dfk
    Quote from TopherSRN
    Read a published source today that said the differences in readings are minimal when the HOB angle is 0-60 degrees. Higher than that and accuracy declines. I rarely keep a patient flat, for obvious reasons. I am also not as concerned with any actual number, rather the trends of said numbers.
    agree... clinical picture will provide more info and treatment modality than said numbers... and i also agree that the old minimum "30 degrees" rule of HOB can and should lay to rest.. what about the pt who HAS to lay flat and is intubated? or the vascular pt who needs to lay flat but sux on a tube? what about the chronic back pain who is intubated, but awake and compliant, who says that laying "such a way" works but is contraindicated to the ol' docs orders? it's endless, and forever will be.. get used to it, or leave !! by the way, i'm still around...
  6. by   tde1992
    thanks for responding. can you give me the name of the article and where i can find it.
  7. by   JiffyGriff
    Left side, keeps the air bubble from entering the RA. If the line was introduced into a swan though you are ok because the swan's introducer seals.
  8. by   diapersprinkles
    does the patient have to be disconnected from the mech vent when taking cvp? because i see some nurses practice it and others don't. i once asked what the rationale behind that and i was told that the mech vent increases the cvp reading. i tried looking at the skills manual but there isn't anything mentioned there about disconnecting the patient from the mech vent while reading cvp. please enlighten me on this. thank you very much.
  9. by   dfk
    Quote from diapersprinkles
    does the patient have to be disconnected from the mech vent when taking cvp? because i see some nurses practice it and others don't. i once asked what the rationale behind that and i was told that the mech vent increases the cvp reading. i tried looking at the skills manual but there isn't anything mentioned there about disconnecting the patient from the mech vent while reading cvp. please enlighten me on this. thank you very much.
    with PPV (positive pressure ventilation), there's a difference in intrathoracic/intrapulmonary/intrapleural pressures. all these can/will affect true CVP readings. this differs in the patient who is (SV) spontaneously ventilating. there is less compression of vessels and more venous return in the SV pt, hence readings will differ.

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