Central Line Placement Anatomy

This video will demonstrate the placement of a central venous catheter in the. The axillary vein courses medially to become the subclavian vein as it passes anteriorly to the first rib.

Pulmcrit Shrug Technique For Us Guided Subclavian Lines

Trendelenburg position allows gravity to enhance central venous filling to create a larger target for venipuncture and minimize risk of air embolus.

Central line placement anatomy. Often the indication for central venous line placement is volume resuscitation and veins are correspondingly poorly distended at the time of placement. Elective under which the line is placed. Top tips for central line central venous catheter insertion.

Catheters can be placed in veins in the neck chest groin or through veins in the arms. They may be inserted by medical surgical anestheticitu or radiology specialists. A long catheter may be advanced into the central circulation from the antecubital veins as well.

This means having a detailed knowledge of the anterior and posterior triangles of the neck specifically the division of the sternocleidomastoid into the clavicular and sternal heads as shown in figure 1 and figure 2. The placement of a central venous line is an essential technique in the treatment of many hospitalized patients. While standard of care for placement of central venous catheters cvcs involves ultrasound guidance physicians should be aware of the traditional landmark approach to line placement.

Central venous catheters cvc or lines cvl refer to a wide range of central venous access devices but can broadly be divided into four categories. Nonetheless some general statements can be made and used when obtaining consent from a patient. Anatomy central venous line placement is typically performed at four sites in the body.

Ideally the distal end of a cvc should be orientated vertically within the svc. The right or left internal jugular vein ijv or the right or left subclavian vein scv. Central lines can have multiple lumens.

Deep to the vein is the anterior scalene muscle followed by the subclavian artery. Positioning the tip of a central venous catheter cvc within the superior vena cava svc at or just above the level of the carina is generally considered acceptable for most short term uses such as fluid administration or monitoring of central venous pressure. After crossing the first rib the vein lies posterior to the medial third of the clavicle at the change in curvature of the clavicle.

Confirm what the line will be used for and how many infusions a patient has to aid your selection of the line with the correct amount of lumens. Alternatives include the external jugular and femoral veins. It is used to administer medication or fluids that are unable to be taken by mouth or would harm a smaller peripheral vein obtain blood tests and measure central venous pressure.

A central venous catheter also known as a central line central venous line or central venous access catheter is a catheter placed into a large vein. Most commonly 34 and 5 lumen lines are inserted. The risk of complications of central line placement varies with the experience of the operator and the conditions emergency vs.

Clinical Cases Portacath