How to Measure CVP

central venous pressure can be monitored to help guide fluid requirements for patients.

Equipment

• bag of fluids set up with an giving set

• three way tap

• extension set

• water manometer

• syringe of heparinised saline

method

• allow the patient to lie in sternal or lateral recumbency and note its position.
• Wash your hands and put on a new pair of clean examination gloves.
• Draw back and flush the patient’s central line jugular catheter with heparinised saline.
• attach the giving set to the three way tap.
• attach the manometer to the top of the three way tap.
• Connect the extension set to the last free connection on the three way tap.
• flush through the extension set with the fluids and attach to the patient’s jugular catheter.
• fix the three way tap so that 0cm H2o mark on the manometer is level with the right atrium of the patient’s heart; in line with the sternum with a patient in lateral recum- bency and approximately midway between sternum and the top of the dorsal spinal process when the patient is in sternal recumbency. for accuracy it is important that the three way tap is fixed in the same position for each reading.
• Close the three way tap to the patient and open to the manometer. fill the manome- ter to the top.
• Close the three way tap to the fluid bag and open to the patient and the manometer.• the level of fluid in the manometer will begin to drop as it flows into the patient’s catheter and then begin to level as it equilibrates with the central venous pressure.
• The reader should ensure that the measurement is read three or more times for each reading and that the set up is the same for each consecutive reading. an average of the readings will produce the final result. normal readings are between 0cm H2o and 10cm H2o. it is important to measure a baseline for the patient and then follow the trend of measurements to make accurate conclusions about the patient’s fluid requirements.
• After taking the measurements switch off the fluids and turn the three way tap off to the patient. remove the extension set from the patient’s jugular catheter and flush the patient’s catheter with heparinised saline.