procedures / devices

Deterioration After Central/Arterial Line Placement

Acute hypoxemia, hypotension, bleeding, arrhythmia, limb ischemia or line malfunction after vascular access.

Recognize

Immediately consider pneumothorax/hemothorax, arterial injury/cannulation, hematoma, air embolism, arrhythmia, malposition and retained guidewire.

Act now

Stop unsafe line use, support ABCs and obtain bedside ultrasound/pressure waveform/imaging appropriate to the suspected complication.

Reassess

Confirm catheter position and distal perfusion; remove or urgently retrieve devices when mechanical, ischemic or infectious complications are identified.

Evidence status

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Actionable Clinical Workflows (17)

Step-by-step ICU Processes

Acute Hypoxemia

From confirming true hypoxemia to identifying the underlying mechanism.

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Initial Hemodynamic Resuscitation & Shock Bundling

From recognizing hypoperfusion and initial crystalloid bolus to dynamic fluid responsiveness assessment and vasopressor targets.

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Vasopressor & Inotrope Initiation & Titration

From first-line norepinephrine titration to multi-agent vasopressor escalation and inotrope selection.

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Refractory Shock Support Escalation

From multi-vasopressor failure to rescue non-adrenergic agents and mechanical circulatory support.

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Deep-Dive Topic Destinations (3)

Reference Knowledge

Central Venous & Arterial Access: ICU Safety & Complicationsprocedures

Ultrasound-guided vascular access, sterile insertion, tip/position confirmation, and rapid recognition of line-related mechanical and infectious complications.

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Pneumothorax & Barotrauma in Critical Carerespiratory

Tension physiology, point-of-care ultrasound diagnosis, needle/finger/tube thoracostomy, and management of bronchopleural fistulas on mechanical ventilation.

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Shock: Foundational Critical Care Frameworkcardiovascular

Cellular dysoxia, DO2/VO2 physiology, the 4 shock phenotypes, dynamic fluid responsiveness (PLR/PPV) vs fluid tolerance (VExUS), and vasoactive pharmacology.

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