Central Venous Catheterization

Published on 22/03/2015 by admin

Filed under Critical Care Medicine

Last modified 22/03/2015

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W3 Central Venous Catheterization

image Before Procedure

image Anatomy

Pertinent anatomy varies depending upon the chosen site of central venous catheterization. All relevant landmarks should be included in the sterile field. For internal jugular venous catheterization, identification of the triangle formed by the two heads of the ipsilateral sternocleidomastoid (SCM) muscle is imperative. It is also important to note the location of the angle of the mandible, the clavicle, and the sternal notch located between the heads of the right and left clavicles. The carotid artery pulse should be located and protected during placement of the needle into the internal jugular vein. For subclavian vein catheterization, identification of the middle portion of the clavicle and the insertion point of the clavicular head of the ipsilateral SCM muscle and sternal notch are important. Femoral vein catheterization requires identification of the junction of the middle and distal third of an imaginary line drawn from the pubic tubercle to the anterior superior iliac spine. The ipsilateral femoral arterial pulse should be located as well.