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Video of an ultrasound-assisted central line insertion through the internal jugular vein. Before insertion, the patient is first assessed by reviewing relevant labs and indication for CVC placement, in order to minimize risks and complications of the procedure. Next, the area of skin over the planned insertion site is cleaned.
It is most commonly placed in the neck (internal jugular) but may also be placed in the groin (femoral), liver (transhepatic), chest (subclavian) or back (translumbar). [3] The catheter is inserted into the vessel under ultrasound or fluoroscopic guidance and tunneled through the skin. Tunneled catheters have multiple channels called lumens ...
Venous cutdown is an emergency procedure in which the vein is exposed surgically and then a cannula is inserted into the vein under direct vision. It is used for venous access in cases of trauma, and hypovolemic shock when the use of a peripheral venous catheter is either difficult or impossible.
In some situations, venous access is obtained by inserting catheters into the large central veins of the trunk of the body such as the internal jugular, subclavian, or femoral veins. This type of venous access is performed with central venous catheters (CVCs) , and is required in certain situations where peripheral access is inadequate.
Throughout the procedure, ultrasound and X-rays may be used to confirm placement. When a central venous catheter is inserted, a chest radiologic examination is usually performed to confirm the position of the catheter and absence of pneumothorax. The chest radiologic examination is integral to the procedure.
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Catheter access, sometimes called a CVC (central venous catheter), consists of a plastic catheter with two lumens (or occasionally two separate catheters) which is inserted into a large vein (usually the vena cava, via the internal jugular vein or the femoral vein) to allow large flows of blood to be withdrawn from one lumen, to enter the dialysis circuit, and to be returned via the other lumen.
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