Central line placement

[bbcdpmohanty]

Forensic free!

[pjmclach]

awesome



[vcuo]

Can we take blood sample through central line without compromise the sample?

[EmilineTDD]

my husband had his port removed yesterday and has been very hoarse, and has been

for about 3 months ever since he had the port put in his shoulder, have you had any problems such as this?

[Cr0gers]

It Fuckin' Hurt..

[ldleold]

i am not willing to risk losing my single kidney to the bypass machine, so this surgery is dead in the water. Leaving this world with heart failure beats kidney failure. Dialysis is out of the question, I watched my grandmother die that way, I am not interested

[ohadguetta]

There is one big missing point - while puncturing the skin toward the jugular vein, one has to point the needle to the direction of the nipple (the right one on this case). By that it kept away from the carotid.

[ldleold]

The heart procedure has been cancelled. I was pushed, shoved, griped and whined into the tests that found the blockages. I WILL NOT risk my only kidney with this surgery. Leaving this place with a heart attack beats dying from kidney failure. I would not go on dialysis if I were to lose my kidney to the bypass machine. YES I know the "stated risk" is 28% that I would lose my kidney in this surgery. It's my choice and I said "no". It took some time to teach the surgeon the meaning of that word.

[MegaSammy004]

I would rather go with I-vad instead of central line as chances of getting infections are way less and I-vads are easy to mailtain no chances of pulmonary embolism.......

[ldleold]

No, I will never again have any medical procedure forced on me, that is why I have a living will that specifically forbids advanced life support. Since I have already suffered two heart attacks that I am aware of I pretty sure that I will not allow this procedure.

[jencheny]

usually the patient is conscious, but local anesthesia is given. general anesthesia isn't preferred because it causes respiratory depression. if you've ever had a tooth out or had sutures, local anesthetics do hurt when they're injected but the entire site becomes numb after that.

more to the point, do know that this is done only when it's necessary. doctors and surgeons don't do stuff like this just for fun, or just to be really invasive to their patients. we do this because it's necessary.

[alynah2010]

ok question.....is the patient concious?

[GallopingCloud]

@alynah2010 i think they usually arent. I'm not in the medical field or anything (im only 14 but highly interested in it) But from what i've seen they've been put under general anesthesia

[MsGailj]

@alynah2010 they may be concious (done under local anaesthetic), sedated or unconcious (under general anaesthetic, as part of a surgical procedure, but you don't give a GA for a CVC line insertion)

[lux0riz0r]

Hm @Idleold There shouldnt be a problem to give you some short narcotic with propofol i.e.

U shouldnt prepuncture the vein with a small needle to prevent bleeding while u chance needles making it harder to hit

[ldleold]

I have refused bypass surgery because this procedure will be done with me awake and with no numbing. I will not risking the nicking of the carotid artery if I should move while the surgeon in probing around trying to hit a target he can't see.

[IdnahT]

@ldleold Well die from an MI instead. your choice right. no disrespect.

[Stugio]

@ldleold Great plan... now it's only a matter of time before your condition deteriorates and you undergo the procedure anyway!

[Genetics82]

@ldleold You should just talk with the doctor beforehand. Most likely, you won't remember this insertion. Also, instead of blind insertion most places do it under ultrasound.

[ldleold]

I glad that I refused surgery now, their is no way I could held still for this procedure.

[ldleold]

I am glad that I refused this now... This no way that I could have held still for this..

[vishwakarma132]

remember to use heparin mixed saline for checking all the ports of the catheter after you insert the catheter...

[jadmd1]

never let go of the wire!!!!!!!

[bugsaregod]

I've been a wake for these. I actually believe the tunnel picks hurt worse. I've also had about 12 regular picks. I hope I never need them again. Now just get IV therapies once a week. I'm really begining to hate needles. Medical people, please never forget your patients have feelings, too many forget this or never knew.

[KaTzUnG86]

me gustaria que se tradusca a español

[cheverisimo1234]

thank goodness i was already put to sleep for bypass surgery before the doctors inserted this. well, to say the least the device and the video really are helpful for those in need as it saves a ton of time + pain of having to restick someone a couple of times a week for a new iv line

[koolchikk2009]

omg.that looks so painful..what is that thing used for anyways

[lijo668]

very helpful

[cheverisimo1234]

for nurses, depends on the state's nursing laws --- in virginia, as a student training to be a registered nurse, i have seen other registered nurses with undergraduate training who have been specially trained in PICC insertions able to perform the procedure under fluoroscopy. however, I think you need to be a nurse practitioner, CRNA, etc to insert jugular lines or subclavian lines in virginia.

[newyorkinthahouse]

Intense stuff! Can't wait to do my first central line!

[favamolle99]

in u.s can nurses suture or put central catheter lines?

[shanquilla562]

@favamolle99 No, maybe not even a CRNA, jugular CV lines suck, bad position for maintenance, but are less risky to install, subclavian CV'L's are better, higher risk on insertion of a pneumo though

[glasgowthree]

I've put hundreds of these in and wish there had been videos similar to this one when I was an M3. I think this is a useful video in that regard; I agree with none24, the nick prior to the dilation was misdirected in this video and the blade portion should be directed laterally. With regard to laying the catheter out on the neck, I'd avoid touching the catheter to the skin if you find that step necessary. This is one of the better videos, though.

[TheLoveLivingLife]

To the very observant yirmeyahu79, I don't think that was air, as the "patient's" head was missing.

[AngemonRulez]

I had this done on me on the 2nd of this month, although it was slightly painful(the numbing agents did shit) I had no idea they were sticking me with needles other than the numbing one.

[Carlitah14]

i go to a medical school and i had to learn this. i didnt know about a central line until two weeks ago. thanks to this video, my presentation i had to show other people was a success! i will be sure to show some future docs [middle/highschoolers] that i know so that they can do well on presentations too:)

[finallyfound1]

Too mad the med student hasn't had an English class. LoLz

[imjustbored]

Too "mad"? LoLz

[superSeanproductions]

looks painful

[yirmeyahu79]

Also of note, the thumb should occlude the hub as soon as the syringe is removed form the Seldinger needle to avoid air entry into the vessel. In the video, this is not done and one can see the air moving into the needle.

[MRGHAMDI]

I still feel nervous about it.....

[none24242]

Always make your cut away from the carotid artery, for obvious reasons.

[BCUboi]

I work in an ICU and the intensivists do these on a regular basis. I never got to witness one at the bedside.

[venomkuda]

Sad to hear that mate, coz you should have a chance to witness that as its a regular procedure in ICU

[tikiora]

Good vid - but remember to flush your catherter with normal saline via all four hubs prior to insertion.

[KarraTasi]

great