EASY Central Line Placement (Central Venous Catheter) | Behind the Knife – Bedside Procedures Ep 2


***As a couple viewers have noted, we accidentally left out the shot where we removed the wire! You should remove the wire after the catheter is inserted over it! 🙂 ***

I LOVE placing central lines! Join me as we learn how to EASILY nail the IJ, subclavian, and femoral central lines. If you haven’t already seen our video on Ultrasound-Guided Access, consider watching that first!

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Intro: (0:00)
Positioning: (0:37)
Landmarks and ultrasound: (1:12)
Gathering Equipment: (2:05)
Priming Equipment: (3:19)
Procedural Steps: (4:10)
Subclavian and Femoral Lines: (10:44)
Outro: (13:01)

Supplies you should gather (many will be in the kit):
Prep stick and drape
Gauze and sterile dressing
Catheter and 3 caps
Local anesthesia, needles, and syringe
Finder needle and syringe
11-blade knife
Skin dilator
Sterile saline flushes
Suture, needle, and catheter fastener
Ultrasound probe cover
Pressure transducer (if available/desired)

Preparation Tips and Tricks:
Clear room at the head of the bed
Bring patient head to edge and place in Trendelenburg with height to your preference
When placing probe cover, remove all folds from the plastic and remove all air bubbles from the gel
Flush catheter lines before use
Ensure guidewire glides smoothly and prime the cheater
Stage all your equipment in order of use

Key Steps of the Procedure:
Infiltrate local anesthesia
Use ultrasound to guide finder needle down to vessel
Place guidewire to 20cm depth
Make nick in skin with blade, then dilate tract
Feed catheter over guidewire, advance to desired depth, remove wire
Aspirate from and flush all ports
Sew in catheter, including using the catheter fastener
Call for confirmatory x-ray

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