Cordis cath ???

allele, LPN · Dec 5, 2004

What exactly is this device and what protocol do you use if you need to access for blood draws?

Okay, don't take this as gospel, because I was only told this, never looked it up. But apparently it's an older name for an IJ (central line). We have a doctor or two that still uses that name for it in their oders (i.e. D/C cordis). I hope someone corrects me if I'm wrong!! :)

zambezi, BSN, RN · Dec 5, 2004

It is just a really big central line, usually placed in the IJ. Our patients do not go to the floors with these in place and we are not allowed to do blood draws out of our cordis' per our hospital protocol just because it is a direct line straight to the heart...not the place you want to be introducing bugs to (not that you want to introduce bugs into any line...)

CritterLover, BSN, RN · Dec 5, 2004

a cordis is a large-bore, usually single-lumen central line. it can be placed ij, subclavian, or femoral. it is also sometimes called an introducer, becuase it is frequently used as a pathway for a swan ganz (pa catheter) or transvenous pacer (the swan or pacer is "floated" through the cordis). it can also be used a a resuscitation line, because its large size (8 or 10 french, i believe) enables rapid infusion of blood and fluids (about 90 seconds for a unit of blood on a pressure bag or through a rapid infuser). the facilities i have worked in have allowed blood draws from cordis lines, with the same protocol as any other central line (5-10 cc waste, flush after blood is drawn). however, it can be difficult at times to get blood from a cordis because they are fairly soft and kink easily, especially if ij. (edwards makes a type of introducer -- i don't know if it is referred to as a cordis or not -- that has three lumens plus a path for the swan or whatever is being introduced, and is nice because the swan doesn't slow down the flow rate the way it does in a single lumen cordis).

rn29306 · Dec 5, 2004

Alot of times you may see these used on trauma center patients. If I am not mistaken, they are a part of the "trauma protocol" at our center. The flow rates are incredible. When used with a Level 1 infuser (pneumatic pressure infuser), a PRBC bag can be infused only as fast as it takes to bend down, open the cooler, and grab another bag, then stand up-----BOOM, bag you just hung is now empty. I would not see their usefulness outsite the ER and OR, or perhaps in the units for a short while (but if the pt is bleeding that bad, then they need to go back for exploratory surgery anyway).

Keep in mind that resistance or flow is equal to the 4th power of the radius. Increase the diameter x2 and flow goes up x16 factor.

Given their large diameters, I would tend to think that accurate lab draws would be difficult considering the amount of waste that needs to be withdrawn even to get a solid red sample (not visibly diluted) is substantial. Several mornings of this and it will be retransfusion time.

No offense meant, but if a cordis is in a patient that is even semi-stable and on the floor, then it needs to be D/C'd ASAP. There is no indication for these in stable patients. If they need a central line, then fine, insert a TLC or QLC over the wire and pull the cordis regardless. They are a short term solution for hopefully a short term problem.

Pulling a cordis line is no joke considering the diameter of the line. Some are single lumen and some are double lumen.

Hope this helps. I would like to hear other's experiences with these and facility protocol when dealing with these lines, esp D/C parameters.

rn29306

CCU NRS · Dec 5, 2004

a cordis is a large-bore, usually single-lumen central line. it can be placed ij, subclavian, or femoral. it is also sometimes called an introducer, becuase it is frequently used as a pathway for a swan ganz (pa catheter) or transvenous pacer (the swan or pacer is "floated" through the cordis)

this is a good explanation of a cordis, i don't know about the trauma uses, we do see them on our cabg pt's and usually with a swan in place, i beleive they always use the cordis for cabg pt's in the event that a swan is evenmtually placed although we do see an occasional cabg without swan.

our d/c protocol is also they don't leave ccu with a cordis, however pulling one is about like pulling an artline 10-15 minutes of direct pressure when d/c'd.

begalli · Dec 5, 2004

Cordis'/introducers are as common on my unit (CT ICU) as are foley caths. I never draw blood from them usually because if a pt has a giant line like an introducer, they also have an art line (which is were we draw our labs from).

We use these humongus (sp?) lines for fluid resusitation or like someone else mentioned, administering blood with a rapid infuser. The rapid infuser pts don't always require a trip back to the OR. Sometimes we just open them on the spot in the room if needed, but not all pts who've been infused rapidly need to be reopened either....depends.

When a pt has a swan, we hook up a maint fluid at a kvo rate to the introducer and piggyback all IV meds through it, sometimes our drips run through it, sometimes we don't use it at all. Not all pts with an introducer has a swan or any other central line. Sometimes it's just there all by itself. (Had a GI bleed last night flown in to us with a solitary line...an introducer in the groin). When a swan is d/c'd, a triple or bi lumen is usually threaded through or else that part is just capped.

When we pull these lines (especially in the subclavin or IJ...not so much femoral), we slightly trendelenberg the pt and ask them to take a deep breath and hold it while the line is pulled (if they're cognitive enough to do so) to avoid an air embolus. We never send a pt out with an introducer.

Anyway, it's such a versatile tool. I LOVE em!

Dinith88 · Dec 5, 2004

Ditto begalli and ccu rn.

We see them on nearly all of our CABG patients as an introducer/sheath for SWAN placement. After we pull the SWAN we often keep the introducer (CORDIS) in place as a nice central-access. I've never seen one placed just for the sake of placing a central line, though...and i was under the impression that their primary purpose was as a sheath/introducer.

Contrary to what RN23906 mentioned, CORDIS sheaths are MUCH more common in ICU's (esp CTICU) than in ER's. Anyone that needs a swan for hemodynamics gets the CORDIS as an introducer. Do ER's even use SWANS?

stbernardclub · Dec 6, 2004

DITTO DITTO DITTO...THIS IS MY EXPERIENCE WITH THEM ALSO...

Ditto begalli and ccu rn.
We see them on nearly all of our CABG patients as an introducer/sheath for SWAN placement. After we pull the SWAN we often keep the introducer (CORDIS) in place as a nice central-access. I've never seen one placed just for the sake of placing a central line, though...and i was under the impression that their primary purpose was as a sheath/introducer.
Contrary to what RN23906 mentioned, CORDIS sheaths are MUCH more common in ICU's (esp CTICU) than in ER's. Anyone that needs a swan for hemodynamics gets the CORDIS as an introducer. Do ER's even use SWANS?

starcandy · Dec 6, 2004

Thank you guys for the wealth of information on this board. I had experience with IJ cordis and couldn't find much info.

rn29306 · Dec 6, 2004

I believe that the term "corids" covers a wide variety of large lumen central lines. In my unit, the introducers that were always associated with floating a Swan catheter (the ones with the side ports) were simply called introducers. Every Swan had one of these, a place for the Swan to enter, then a very large side port single lumen. Now at a large trauma hospital, anesthesia refers to a "cordis" as one of the large lumen either single or dual lumen lines strictly for the purposes of rapid volume resuscitation. It is a part of the protocol for trauma patients. The term introducers and cordis lines are not interchangeable at our facility.Cordis the company even has a poster on the invasive radiology suite as the introducers they use in femoral access for angiography, balloons, etc are also called cordis. I never meant to imply that units never had "introducers" or that those lines were called "corids" lines. My apologies.

It is all in where you practice and what you call them.

CCU NRS · Dec 6, 2004

Thank you guys for the wealth of information on this board. I had experience with IJ cordis and couldn't find much info.

You are more than welcome we love to be helpful and this is a great resource for straight poop from nurses in the trenches, as it should be we are alll commrades in arms!