Central Line Hot Takes

Last updated over 1 year ago

7 questions

Last updated over 1 year ago

7 questions

Question 1

Which Patient would require a central line?

The ICU patient requiring high doses of Propofol and Fentanyl for ventilator synchronization.

A Med Surge patient on day 4 of an ileus who is starting TPN this evening

A 72 year older cancer survivor post chemotherapy receiving IV antibiotics for a UTI

A 39 year old male who is detoxing from ETOH and has pulled out 3 IVs in the last 16 hours 

Question 2

Every 7 days

Monday nights

Every 5 days

Only when visibly soiled

Question 3

Obtain an order for Stat central line insertion

Do not delay care and infuse through a 20g IV in the antecubital 

Do not delay care and infuse though any functional IV

Question 4

An 84 year old male here after a fall at home requiring multiple incompatible IV infusions with limited IV access.

A 27 year old female who is Septic from a UTI and suffering from Disseminated intravascular coagulation

A 76 year old female with urosepsis requiring vasopressor support

A 32 year old cancer survivor with poor peripheral access who needs IV antibiotics for his RLE cellulitis

Question 5

Keep the PICC line in place since the patient is a fresh ICU transfer and was on Levophed yesterday.

Vancomycin is caustic when infiltrated and a central line should be used. 

Attempt to obtain a peripheral IV and discuss discontinuation of the PICC with the provider.

PICC lines can remain in place for extended periods there is no need to address at this time.

Question 6

Use a 20cc syringe of 0.9%NA to ensure continued patency

Using a 10cc 0.9%NA flush 1ml at a time with brief pauses to get a turbulent flush ensuring patency

Using a 10cc 0.9%NA flush give a smooth continuous flush to avoid damaging the catheter and maintain patency. 

Using a 5cc 0.9%NA flush push quickly to ensure patency 

Question 7

True

False

Question 1

The ICU patient requiring high doses of Propofol and Fentanyl for ventilator synchronization.

A Med Surge patient on day 4 of an ileus who is starting TPN this evening

A 72 year older cancer survivor post chemotherapy receiving IV antibiotics for a UTI

A 39 year old male who is detoxing from ETOH and has pulled out 3 IVs in the last 16 hours 

Question 2

Every 7 days

Monday nights

Every 5 days

Only when visibly soiled

Question 3

Obtain an order for Stat central line insertion

Do not delay care and infuse through a 20g IV in the antecubital 

Do not delay care and infuse though any functional IV

Question 4

An 84 year old male here after a fall at home requiring multiple incompatible IV infusions with limited IV access.

A 27 year old female who is Septic from a UTI and suffering from Disseminated intravascular coagulation

A 76 year old female with urosepsis requiring vasopressor support

A 32 year old cancer survivor with poor peripheral access who needs IV antibiotics for his RLE cellulitis

Question 5

Keep the PICC line in place since the patient is a fresh ICU transfer and was on Levophed yesterday.

Vancomycin is caustic when infiltrated and a central line should be used. 

Attempt to obtain a peripheral IV and discuss discontinuation of the PICC with the provider.

PICC lines can remain in place for extended periods there is no need to address at this time.

Question 6

Use a 20cc syringe of 0.9%NA to ensure continued patency

Using a 10cc 0.9%NA flush 1ml at a time with brief pauses to get a turbulent flush ensuring patency

Using a 10cc 0.9%NA flush give a smooth continuous flush to avoid damaging the catheter and maintain patency. 

Using a 5cc 0.9%NA flush push quickly to ensure patency 

Question 7

True

False