From Vascular Networks to Urban Infrastructure: Lines Connect Us

Lines—Connecting Life and Cities

Lines in systems are a conduit from one point to the other. They form networks that create convergence or demarcation and establish direction. In the cardiac ICU where I am currently precepting, lines references many different treatment or assessment modalities; a Swan-Ganz is a form of PA catheter, a multi-port diagnostic tool that allows nurses and providers to manage critical illnesses like shock or heart failure. Arterial lines allow for continuous hemodynamic monitoring and blood collection with ease (most times). Vascular lines connect potent pharmacological therapies to the patient’s internal vessel structure, routing life-saving treatments in the most direct route possible. Lines are so important, nurses (usually) trace each one at the beginning of the shift, from its source to the patient to visually appreciate what is connected.

You could even call them lifelines.

In architecture and urban planning, lines are a tool for organizing space, creating visual systems for direction and flow. Lines are both conceptual and physical components of the cityscape. Urban networks maintain flow and connectivity because of the infrastructure of lines that keep things going: think water and sewer lines or metro lines.

CVCs, Arterial Lines, PICC Lines—Placement is Everything

Vascular lines in ICU care are a big deal, and much is done to prepare for placing and removing them. The placement of lines in the human body must be precise, often involving the coordination of an interdisciplinary team. Residents, with physician guidance, establish sterile fields and rely on the support of nurses and nursing assistants. When lines are removed, it could be thought of a change in status for a patient: either a sign of improvement and therefore less of a need for invasive hemodynamic monitoring, or a sign of demise. Visualization instrumentation such as ultrasound technology allow for accurate insertion of lines, and the sterility of the environment ensures pathogens are kept out. In this manner, lines divide.

Circulation and Connectivity: Cities as Living Systems

City infrastructures depend on the free flow of traffic guided in part by the lines painted on the pavement. Pedestrian crossings designate who can go where and command the authority of automobile drivers. Traffic lanes keep cars flowing and metro lines keep people going, and in this sense lines define movement through the city. When these lines remain open, life and vitality happen, but when something occludes this flow, a change of events can trigger an entire city to arrest. Much like circulation in the body, the consequences can be devastating unless immediate actions are taken for congestion management.

Bloodlines and Lifelines: Comparing Bodies and Cities

Systems thinking allows for both nurses and urban planners to view life through a critical lens to impart flow optimization. Parallels between vascular networks and city planning abound. Though distinctly separate environments, ICU and urban planners allow both to appreciate the importance of proper planning, infrastructure maintenance, and coordination. Critical care nurses plan the flow of their day, from tracing their patient’s lines and drips at the beginning of the shift, to influencing the lines of communication between the interdisciplinary team during rounds. They zero their arterial lines to ensure accurate readings and flush their PIV lines before pushing meds. Drugs flow in; blood flows out, and the critical care nurse works diligently to maintain this efficient vascular network flow. Urban planners assess the needs of cities and their inhabitants, so that they can better design a built environment that maintains the flow and prosperity of the stakeholders who rely on it.

Conclusion

Optimizing your Own Lines: Lessons from ICU and Urban Design

The intent behind the Vaso & Vibes brand is to help others optimize their lives through the curious lens of an urban planner-turned-critical care nurse and self-professed Mama Bear. The rationale behind this post is to draw parallels between the lines of architectural structure and urban design that border our built environment and the vascular lines used in catheter management and hemodynamic monitoring by ICU nurses.

Utilize these life and city connections to improve flow, create efficiency and enhance the systems that scaffold life.