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PRESSURE
CENTRAL VENOUS
PRESSURE
DEFINITION
• subclavian vein
• jugular vein
• basilic vein
• femoral vein
CENTRAL VENOUS
PRESSURE
EQUIPMENT SUPPLIES
• cutdown set • 3-way stopcock
• CVP catheter (12-24 • CVP manometer
inches long) or feeding
tube (Fr.8-Pedia) or • betadine, cotton
Triple lumen catheter balls, OS 4 x 4,
(optional) gloves, tapes, syringe
• infusion solution / • local anesthesia
infusion line • IV pole
CENTRAL VENOUS
PRESSURE
• Nursing Responsibilities:
A. Pre-insertion phase
1. Assemble equipment
2. Explain procedure
3. Obtain consent
4. Baseline vital signs
5. Skin preparation
6. Position: flat or slightly trendelenberg
CENTRAL VENOUS
PRESSURE
B. Insertion Phase
1. Stay with the patient (reassurance)
2. Lidocaine infiltration/Lidocaine
bolus (standby)
3. Observe fluid fluctuation with
respiration when attached to CVP
manometer.
CENTRAL VENOUS
PRESSURE
B. Insertion Phase
b. Mercury System
2 - 6 mmHg
Phlebostatic Axis Drawing
PHLEBOSTATIC AXIS – halfway
bet. Landmarks 1 & 2
INDICATIONS
• Increased CVP
- Right Ventricular Failure
- Volume Overload
- Tricuspid Valve Stenosis / Regurgitation
- RV Infarction
- Pulmonary HPN
CENTRAL VENOUS
PRESSURE
INDICATIONS
• Decreased CVP
- Reduced circulating blood volume
(Hypovolemia)
CENTRAL VENOUS
PRESSURE
C. Post-insertion Phase:
2. CVP reading / recording
c. Fluctuation with inspiration
d. Record reading when level of
solution or fluid stabilizes
e. Normal value:
5-12 cm H2O
2-6 mmHg
CENTRAL VENOUS PRESSURE
2. Hemorrhage Presence of
disconnection, leaks,
open stopcock
- Observe phlebostatic
axis