Ultrasound (2D) guidance is recommended for central venous line insertion in elective and emergency situation to allow knowledge of the local vascular anatomy. It significantly decreases the failure rate, complication rate, and number of attempts required for successful access
Precautions
Indication
Contraindications
Choice of Vascular access sites
Internal Jugular Vein
Compressible vein if bleeding. US is useful. Arterial puncture is possible. Risk of pneumothorax or haemothorax. Need to place the patient in a head-down position which can exacerbate cardiac and respiratory failure.
Subclavian Vein
Not Compressible vein if bleeding. US can be useful. Arterial puncture is possible. Risk of pneumothorax or haemothorax. Need to place a patient in head-down position which can exacerbate cardiac and respiratory failure.
Femoral Vein
Very compressible vein if bleeding. US is less useful. Anatomy NAVY - the Nerve/Artery/Vein and Y fronts! so vein is most medial structure. Arterial puncture is possible. Risk of pneumothorax or haemothorax. Place person in head-up position which can help cardiac and respiratory failure. Higher infection risk.
Equipment
Technique
Complications
Central Venous Pressure
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Central Venous line Insertion
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