A-lines vs. Central Venous lines

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I'm a new grad who is also new to the SICU...I know this sounds lame but I'm having some probs figuring out the differences about central lines. What exactly is different about an A-line verses a CV-line? Why is the subclavian the preferred site? Why would a doc choose to put in one vs. the other? I feel cheesy that I don't get this yet..but I'd rather ASK! Thanks in advance!

Specializes in critical care.

Hey,

also no subclavian if pt has lots of peep on the vent-PNEMO. We tend to use lots of femorals where I work. Patients don't usually ambulate and usually end up with a PICC before they are through (when we pull the fem) CAT

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Specializes in ICU.
Whoever explained that to you was wrong. You can clamp down HARD on a groin...not so on someone's neck (for many reasons). Think about it...would it be easier to control an inadvertant puncture of a carotid artery or a nicked femoral artery? With coag issues to boot??

If i were you I would re-visit this with your instructor/mentor/whoever.

No I was told the same thing by one of our Cheif Residents. He said that they should never do a subclavian if they have coagulopathic issues. We only use the fem site if we need a line fast, or cant get in IJ or SC. Obviously its prefered to use IJ over fem, so we use it only as a last resort.

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Great stuff (as a beginner myself, I recognize easy to digest info, LOL)

Thought I'd add the explanation (probably already in the Wikis) that CVP is an indicator of fluid status... overloaded, good, or dehydrated. A-line blood pressre gives the info of a usual blood pressure... the parts that go into creating a BP- pump/contactility, volume/preload, and squeeze/afterload. It's not at all unusual to have pts with both types of lines. Oh, and femoral CVC makes a great access for meds and luids in an emergency but usually cannot be transduced (hooked up to a pressure monitor) accurately. At least not with the catheters we keep on our floor.

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Specializes in ICU, Agency, Travel, Pediatric Home Care, LTAC, Su.
2 big reasons why IJ/SC sites are preferred over groin sites...

1) a patient usually cannot ambulate with groin line (risk of bleeding, etc.)

2) Just like mom used to say..' the groin is a dirty place' :cool: (higher risk of infections)

which is why they haveto come out sooner (like someone else said)

Apparently these reasons outweigh the fact that groin insertions are far less risky (they're more readily compressable(sp?) if bleeding developes (nicked artery/etc.), and you can't drop a lung (pneumothorax))

I second that "the groin is a dirty place." IF for some reason a groin line is placed, it cannot stay in nearly as long as an IJ/SC site for this reason.

If a SC line is placed, don't forget your stat portable Chest x-ray to check to make sure they did not drop a lung.

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