Circulation Skills 3:
Central Venous Pressure Measurement
The saline manometer method of measuring central venous pressure (CVP)
is quickest and most reliable in a critical emergency. When a patient is prepared
for central line placement, place the patient is in Trendelenburg position to prevent
air embolism. Put the patient on a monitor so irregular heartbeats can be detected
immediately. If this occurs, pull the guidewire back.
Shoot for a CVP of about 8 cm of H2O. Administer a 10 or 20 mL per kg bolus of saline to achieve this.
- Flush the IV tubing to the patient.
- Fill the saline manometer from the IV bag.
- Open the saline manometer to the patient. The saline level will drop
to the patient’s CVP and move up and down with respirations.
Normal CVP in cm of H2O is 4 to 12. To convert readings to mm Hg, multiply the pressure in cm of water by 0.7. A reading of 7 cm H2O is equal to 4.9 mm Hg.