But how much time will a central line save you Matt? Apart from the
additional time placing one, you've then only gained a small advantage in
terms of patient circulation of the drug. Remember that even your centrally
given drug will not only have to reach the right heart, it will then have to
circulate through the pulmonary circulation, then back to and through the
right heart, and then either through the coronary arterial system or through
the systemic arterial system (depending on the drug) before reaching its
target tissue. I'm not convinced the distance from antecubital fossa to
great veins is that big a saving when you put it in this context.
But if you're struggling for peripheral access, another option is to go for
an external jugular, i.e. just place a peripheral line in the ex jug vein,
which is tantamount to central venous access in terms of position. They are
tricky to place however as the ex jug is very low pressure, and clearly
can't be "tourniqueted" up to peripheral levels of venous pressure! But
because it's a low pressure vein, you'll find it's always there, even in
IVDU patients.
AF
----- Original Message -----
From: "Dunn Matthew Dr.
Subject: Re: Central lines
> > But aren't you labouring under the misapprehension that giving drugs
> > actually does some good for cardiac arrest patients?
> >
>
> Possibly. I like to think I'm keeping an open mind as to whether they do
or
> not, while remaining convinced that by the time any drug has made it from
a
> peripheral line to the myocardium in a cardiac arrest, the patient's brain
> is irretrievably damaged. Evidence that drugs work is at best limited, but
> if they do, giving them by a central line (provided you can place a line
> safely, rapidly and accurately- which you can with the Secalon T and a bit
> of practice) should be better than giving them peripherally.
>
> Matt Dunn
>
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