CENTRAL LINE MEDICINE ADMINISTRATIONS AND HOW TO SEPERATE MEDICINE ADMINISTERATION ACCORDING TO THE PORTS

I would like to share some basic information from my ICU experience.If any corrections u can drop the comments which will be useful to avoid the mistakes in the future.

*1.CENTRAL LINE:*

Central line has three ports.

*Proximal port

*Medial port

*Distal port

DISTAL PORT:Connect only Inotropic supports.

For example:Inj.Levophed.Inj.Adrenaline,Inj.vasopressin,Inj.Dopamine.

NB:Don’t connect other infusion in this port in order to avoid the hemodynamics instability of the patient.

2.Medial port:connect only sedations and paralytic agents.

For example:Inj.Fentanyl,Inj.Dormicum,Inj.Propofol,Inj.Nimbex.Inj.Precedex

**PROXIMAL PORT:*

1.Connect Transducer for Cvp measurement.

2.Attach some additional three ways for basic infusions like,Inj.Heparin,Inj.Insulin,Antibiotics through this port.Keep the near end of this port to keep free for giving emergency medicines when crisis occurs.

*CENTRAL LINE DRESSING*:

1.Change the central line gel dressing if soiled otherwise no need to change.

2.Normal dressing can be changed regularly.

PATIENT ASSESSMENT AND PRESENTATION IN ICU NURSES OUTLOOK

ICU protocol: How to present a patient. 

Presenting the case like start with:

1.*Neurological status*:patient like Conscious  or sedated(GCS ONLY FOR THE BRAIN INJURY PATIENTS).

*2.CARDIOVASCULAR STATUS*:Inotropic supports,Any anti hypertensive drugs like Norvasc,Lopressor.

*RESPIRATORY SYSTEM:*

1.Ventilator parameters

2.ABG values 

3.If there is any change in ventilator parameters kindly document in the oxygenation paper and do the repeat ABG as per doctors order.

4.*GI SYSTEM *

*Feeding

*If normal diet mention about how many meals patient took.

*Bowel movements and laxatives 

*LFT values (Normal or deranged)

5.*RENAL SYSTEM :**

*Total urine output last 24 hrs.

*Fluid balance.

*Renal parameters for example:Urea,creatinine,sodium and potassium.

6.*HEMATOLOGY:*

*Hb level and coagulation parameters 

*medications like Heparin,Clexane,aspirin and plavix.

*7.INFECTION POINT OF VIEW:*

*Wbc level

*Sepsis marker

*Antibiotics

*febrile or afebrile.

8**.ENDOCRINE SYSTEM:**

*Blood sugar level

Keep the target between 10 -12