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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Abnormal Central Venous Pressure
Deborah J. Cook, David L. Simel
Examining patients with indwelling central venous catheters provides the clinician with an...


Topics Discussed: central venous pressure, measurement of, central venous pressure-biological function

Excerpt: "Examining patients with indwelling central venous catheters provides the clinician with an opportunity for calibrating and periodically testing clinical skills for evaluating CVP. Of course, the examination should be performed blind to the catheter reading. If the examination is also conducted blind to other patient data, interpretation of waveforms can be compared to electrocardiograms and other data from cardiac investigations. Learning aids such as pocket cards displaying the normal jugular pulsations may also be helpful. Assessment of JVP in patients with tachycardia, irregular cardiac rhythms, and rapid and deep respirations and those requiring mechanical ventilation provide a challenge for even seasoned clinicians.22..."
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