Central venous access

Headline
Indication - Concentrated electrolyte replacement
- CVP monitoring
- Giving medications that would otherwise be irritant to smaller veins
Contraindication
Kit See shopping list below
Sets work on Seldinger principle
Technique/landmark Sites of choice:
- internal jugular vein
- femoral vein
- subclavian vein (depending on where you are in the UK)

USS guided is generally accepted nowadays
Confirm position of guidewire first by scanning again
Confirm position of line with gas, transducing and CXR (CVAD position on CXR)
Ongoing management Consider timing of line changes
Vulnerability to infection

#incomplete #procedures

shopping list

Insertion pack, which includes (check before scrubbing):

  • Sterile tray
  • Gauze swabs
  • 5ml syringe
  • Size 10 blade
  • Orange needle
  • 2x 10ml syringe
  • Sterile gown + towel
  • Sterile gloves
  • Mask
  • Gallipot (optional)
  • Suture
  • CVC - check length and number of lumens (includes bridge)
  • Bungs
  • Lidocaine (if needed)
  • 0.9% saline (flush)
  • Sterile dressing with antibiotic patch
  • Sterile probe cover + gel
  • Ultrasound machine