ultrasound guided central venous catheter placement

[saidgaber15]

very nice

[kemoantem]

well done!

[1shukhrat]

It is not bad review for beginners. Regarding ultrasound guided subclavian vein cannulation: I believe it is not just difficult - it is simply impossible. Where axillary vein is becoming subclavian? At the crisscrossing of the clavicle and first rib. What you show in your video is cannulation of the distal axillary vein, not subclavian one - if your probe is in the infraclavicular area.

[ekimnage413b]

it has not been proved to " decrease time required for line placement".

[DrJeanVALLA]

Hi, I am a thoracic and cardiovascular surgeon. I learned to insert central lines and port a cath with blind methods. Since about five years I insert my port a cath with echography guidance. I can say that it's very quick, safe and easy.

Your video is very demonstrative an a good skill to learn the method.

I have done a video on this procedure

[nephron365]

Excellent Video...Iam a Resident in Nephrology and Your Video has inspired me to excel our work...One doubt...What about the use of TransVaginal probe for looking vessels...

[hqmeded]

you could use a tv probe since it's high frequency if that's all you have, but a vascular probe would be better.

[janicesono]

Of course, sterile glove is better than no covering, but for catheter insertion full ASEPTIC technique MUST to be used. Non sterile items cannot be held over the sterile field. Your are breaking the sterile field. I suggest static method vs dynamic if you cannot guarantee contaminating the field.

[marcelolannes]

Hi,

How will you advance the wire while watching the image on the longitudinal positional? Are you using an assistant to do it for you?

[hqmeded]

yes, you could have an assistant hold the probe for you.

[janicesono]

Becareful of advice in this video

1) sterile gloves should NOT be used as the cord is not covered creates a NON sterile environemnt

2) short axis -- The needle tip IS visualized if you understand that the scan plane is only 1 mm thick and that the FIRST echogenic dot that is seen as you past the needle under the transducer is the tip. Ring down artifact is the shaft! YOu must follow the tip to the target.

[hqmeded]

@janicesono

if you do not have a commercial sterile probe cover, you can use a sterile glove - though you may need an assistant to hold the probe cord off your sterile field. this would be better than not using any probe cover.

[rodrigogallindo]

In my hospital we use a cover for cameras of video assisted surgery. It's long and protects the probe and the cable.

[njnikusha]

thank u so much 4 vid, huge vascular fan

[breandan41]

Many thanks for an excellent teaching resource. I presume you won't mind if I use this for my junior staff?

Brendan - Emergency, Waterford Ireland

[hqmeded]

Yes, please use it. We're glad it's helpful.

[paulsniusa]

Hi I'm studying Vascular Technology and we are covering this topic now in class. I will forward it and use it as a class example.

[midaztouch]

Excellent video. Thanks. My hospital's OR doesn't have one of these (small community hospital). Cath lab has one but they don't lend it out. I also think it's good to learn how to do it without US, just using landmarks and carotid pulse. The US machine may be broken, out of batteries, in use, or otherwise unavailable. If you can't do it the old-fashioned way, then you (and the pt) will be SOL.

[DeadChocobo]

very informative.