Setting up for a central venous catheter (CVC) is an essential skill for peri-anaesthesia nurses. There is a lot to remember, and not all sterile packs are the same! 🤓
Here are the considerations for CVC setup:
Before procedure:
1️⃣ Must be performed in a “cardiac protected” area
2️⃣ Consent & allergies must be checked
3️⃣ Check if you need a “double transducer” set up (for both arterial and central pressure monitoring).
4️⃣ Apply standard ANZCA monitoring and oxygen (if sedating an awake patient)
CVC “SETUP”
Use our SETUP mnemonic to ensure you don’t miss anything! Be sure to have a large table upon which you can open your sterile equipment.
S - Sterile pack and CVC Kit
👉 Ensure catheter length and number of lumens is correct
👉 15-20cm catheter with 3-4 lumens is most common in the peri-anaesthesia setting
E - Extras (if not already in sterile pack)
👉 Sterile Gown & Gloves
👉 Saline for flushing
👉 Sterile gauze
👉 Sterile dressing
👉 Sterile drape
👉 Skin prep
👉 Syringes, scalpel and 23-25g needles
👉 Suture & needle holder
👉 Scissors
👉 Sterile gauze
👉 Local anaesthetic (if awake)
👉 Enough pressure valves (bungs) for each lumen
T - Transducer set
👉 See our 4 P’s of preparing a transducer set in our Concept Series article on Arterial Line Setup
U - Ultrasound
👉 Linear high frequency probe
👉 Sterile probe cover
👉 Sterile gel
P - Positioning
👉 To optimise venous filling (and therefore safety), the patient is often tilted head down for internal jugular and subclavian insertion.
👉 The insertion area should be free of ECG leads, patient hair, tube ties and circuits.
After procedure:
1️⃣ Ensure the transducer set is labelled correctly
2️⃣ Document the insertion
3️⃣ Safely discard sharps and confirm guidewire has been removed
4️⃣ Arrange a chest X-ray if required to confirm position
Now you’re ready to set up for a CVC!
Build knowledge ✅
Improve safety ✅
Ref: https://www.perioperativecpd.com/wp-content/uploads/2024/03/CVC-2020f.pdf
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