Help! New nurse and arterial lines!

[new nurse stl]

Hi everyone! I'm a new member and this is my first post, so I sure hope someone can help!:)

I am a new graduate and I work in a CVICU. My preceptor is a wonderful teacher and very patient with me. However, I am having a very hard time understanding the cockstops on arterial lines as well as other lines.

When zeroing or drawing blood, which way is "off to the patient" and which way is "off to the system?" Is there an easy way to understand this?

Everyone says that it takes time, but I have so many other things to learn and almost every patient I have, has an arterial line.

Please help....

[ittybabyRN, RN]

well in simple terms..."off to the patient" usually looks as it sounds, the stopcock is turned until it is facing the patient, in other words, it should be turned/pointed at wherever the line enters the patient/the direction you would get blood from if pulling back

off to the system is the opposite, turn the stopsock away from the entrance point and towards the fluids/trancducer etc that it is attached to, you would do this if you were going to be getting labs for instance

[new nurse stl]

Thank you for your reply and the helpful information!

[Maevish, ASN, RN]

You know what? For some reason unknown to me, I also had a hard time with this, and even now, I still see nurses pause and think before they turn a stopcock one way or the other. When you have a pt with a Swan, a PICC line, an aterial line, and a line for doing bladder pressures, believe me, you WANT to stop and think "just to be sure".

I just always remember that "off to the pt" means (when zeroing art lines, cvp, bladder pressure setups anyways) to turn it toward the hard part of the tubing. And like I said, its not a hard concept at all when it clicks in your head, but it's crazy what the brain just refuses to "get" sometimes! Haha :-)

Xoxo

[edogs334]

I'm also a new graduate and still have to think about which way is which. The way I've found it to follow the line in either direction from the the stopcock on the transducer- one direction will go towards the pressure bag and the other will go towards the patient. Or you could just find out the hard way by opening the stopcock in the random direction of your choice, in which case blood may or may not begin to drip out of the port on the stopcock.

[CCL RN, RN]

Yup, when I was learning I turned it towards the hard part of the tubing. We are zeroing the system, not the patient. So you turn it towards the pt so that the system is all open and ready to be calibrated.

[NtannRN]

We use "vamp" set ups. On central/a-lines, I came across an issue I wasn't told about. We have s 10 cc chamber in the set up for our "discard" that we reinfuse after we draw blood. Well there is a stopcock there so you don't draw from the discard. Don't forget to reopen the stopcock before reinfusing. I forgot ONCE, the blood backed up into my transducer and I had to get a whole new set up. What a PIA that was. :smackingf:smackingf:smackingf

[Biffbradford]

Make sure your connections are tight on the pressure tubing. Don't assume they are when setting a new one up. A few of my patients got a 3am shower they weren't expecting.