Central Line

Central Line Insertion Landmarks

noreply@blogger.com (Anonymous) — Thu, 02 May 2013 12:45:00 +0000

Femoral-Just medial to the femoral pulse. If absent try to feel for pulse with compressions or use your hand. Put your thumb at symphysis pubis and index on ASIS. Aim for just medial of the middle of the “V”
Internal Jugular-Just between the bellies of the sternocleidomastoid muscle.
Subclavian-outer third of the clavicle and direct needle towards sternal notch. Go just under the clavicle

noreply@blogger.com (Anonymous) — Thu, 02 May 2013 12:44:00 +0000

Time Out Procedure
Prep the area with chloroprep with or without betadine and sterile drape in the usual fashion
Palpate the appropriate landmarks (see below)
Once you get venous return, thread the guidewire (seldinger technique), remove the needle.
Make an incision at the top of the wire with an 11 blade scalpel.
Dilate the wire with dilator and remove the dilator
Thread the catheter over the wire and remove the wire when advancing the catheter.
Always have a hold of the wire before advancing catheter.
Get a STAT portable CXR to confirm placement
It is considered the standard of care to use ultrasound guidance for internal jugular and femoral vein catherization if it is available to you.

noreply@blogger.com (Anonymous) — Thu, 02 May 2013 12:40:00 +0000

noreply@blogger.com (Anonymous) — Thu, 02 May 2013 12:37:00 +0000

noreply@blogger.com (Anonymous) — Thu, 02 May 2013 12:36:00 +0000

noreply@blogger.com (Anonymous) — Thu, 02 May 2013 12:33:00 +0000