[youtube https://www.youtube.com/watch?v=RgvidbCYN6E&w=750]
Cite this post as:
Scott Weingart, MD FCCM. Central Venous Pressure (CVP) and Arterial Line Set-Ups. EMCrit Blog. Published on November 29, 2010. Accessed on December 7th 2025. Available at [https://cmefix.emcrit.org/squirt/pressure-set-up/ ].
Financial Disclosures:
The course director, Dr. Scott D. Weingart MD FCCM, reports no relevant financial relationships with ineligible companies. This episode’s speaker(s) report no relevant financial relationships with ineligible companies unless listed above.
CME Review
Original Release: November 29, 2010
Date of Most Recent Review: Jul 1, 2024
Termination Date: Jul 1, 2027
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Hi Scott! Great video. Believe it or not, I watched this on my iPad standing over a intubated patient, while setting up an A-line set! I’m at a small hospital where none of the nurses knew how to set it up…worked just fine, though!
WOW, great tutorial. Thanks.
Thanks Scott! I used to measure it by ruler for a long time. Yesterday is the 1st day to set up with the monitor (Nihhon). Thanks for sharing this!!
We recently installed new monitors that allow us to monitor CVP and I really need a little more than 10 minute review. Thank you.
Amazing video, thanks for taking the time!
Great video for teaching others!!!!
Great video! Very helpful! I’m in a critical care residency right now and have to set one of these up come Monday. Thanks!!!
Wow, thanks so much!
Great video and incredibly helpful for a quick refresher! Thanks!
I do a lot of these; this is a great tutorial. I just want to mention an easier way to purge the air from the saline bag at the beginning of the set up. After spiking the bag and squeezing and filling the chamber of your line set, turn the bag upside down and poke an 18 gauge blunt fill needle into the medication injection port of the NS bag. The needle is not attached to anything. Squeeze the air out until you get a few drops of saline out of the needle hub and withdraw the needle while squeezing the bag. This purges the all the air out of your bag and I find it makes priming the line without air bubbles a little easier. Of course, the saline bag is not under pressure while doing this. Pressurize after purging the air. Thanks SW!!
Phaedra, thanks for the comment. This definitely works. Can’t say it is easier though. Requires a needle, requires sticking through the port and then disposing of the needle. Vs. just flushing the air through the system which you have to do anyway. Both work so go with what you like.
great video. new ICU nurse and this was extremely helpful.
Any thoughts on attaching a VAMP to your pressure set up when monitoring CVP? There is the constant back and forth about whether a VAMP will actually affect your CVP reading. I feel that in the septic patient who is requiring resuscitation the VAMP helps minimize the amount of blood you are wasting when doing the repeated lab draws (and we know they need whatever they can get)! I am an RN/educator; we are currently planning some Invasive Monitoring education sessions and would love to get some feedback about this. Thanks 🙂
think we are best off avoiding blood draws from central lines whenever possible (exception being scvo2). We have inline vamps for our art lines for just the reason you mention
Great video Scott!!! It’s very didactic.
Greetings, Scott.
My name is Mykl and I am an ED RN in California. This video was very informative and I appreciated some of the more technical points you mentioned. I have a question, though. After locating the phlebostatic axis and prior to establishing CVP, does it matter much which position their head is in: supine versus elevated? Do you have a recommended level the head should be at?
Thanks.
M.
whole point is to always keep the transducer at the level of the phleb. so put it htere regardless of where the head is. if you tape it to their chest it will always be in the right place regardless of their position
This is an Awesome tutorial! And I can’t wait to watch others. I also really applaud your mission to “bring upstairs care downstairs” as an Icu nurse I appreciate that.
Alyssa RN
Great video, Scott. I’m a traveling doc for EMP and I find that this is a novel procedure in many community ED’s. Would the setup be the same for checking a bladder pressure when evaluating for abdominal compartment syndrome?
Sean
yep in terms of pressure bag. you need to instill 60-100 mls of fluid, clamp the foley, get a angiocath into tubing distal to clamp. zero at phlebostatic
I may be wrong, but I was always taught that a bladder pressure is never performed with a pressurized system, and the amount necessary to bolus is 20ccs. Zero to room air. Keep your transducer at the level of the iliac crest. Always bolus at end-expiration, as you would with any other type of transduced line. Wait 1-3 seconds for the pressure to level out, and that’s your measurement. You don’t need an angiocath if you have a facility with a three-way set-up, and you always infuse above the clamp. Of course, with a proper set, you don’t need to clamp the foley, but if it’s homemade from an artline kit then you do. My first hospital we had bolus COO kits and we rigged them with an artline set to work.
It worked fine–problem, as always, is getting someone to do what is reasonable with the numbers.
Thank you I am a new anesthesia nurse/ tech in the OR coming from geriatrics and assisted living I have been struggling with this amongst other things . You’ve explained it in the most simple simplistic way steep by step better than my co workers !
In going to stalk your page to hopefully find more videos thank you for this thank you I’m 5 years late but the methods are pretty much the same !
: )
i can’t recall which episode you talked about converting peripheral iv’s to midlines with a special
kit. which was it? what is the kit. What about sterility? How long can it be left in? How do you know if the iv that was in is in a vein that would allow a midline catheter?