CVP-Central venous catheter Placement using seldinger’s techniques

 It is the procedure mainly used for the CVP-continuous central venous pressure monitoring and for purpose of the fluid management, drug therapy etc. central venous catheter is placed either in the internal jugular vein or subclavian vein, femoral vein, axillary vein.

Indication

Infusion and fluid volume therapy

Parenteral nutrition

For the administration of the high osmolarity solution

administration  Very vein irritant drugs/solutions

intermittent central venous pressure monitoringCentral venous catheter

for venous blood sampling

for the no peripheral venous access

patients with injured extremities

for the shock patients

Material used

Seldinger needle or valve needle

Guidewire with length marking flexible J- tip /straight tip

Scalpel  11 size with BP handle

Dilator

Double lumen /triple lumen made of an opaque catheter made of polyurethane with a soft tip

With valves and three-way adapters

Colour coded Luer lock connection

Fixation wings for the fixing the catheter

Luer lock syringe

Ultrasound sterile jelly

Drapes for the site (center hole )/normal drape

Tegaderm /condom or sterile gloves for the ultrasound probes

Drape for the ultrasound cable

Sterile solution for the skin preparation and alcohol-based disinfectant.

The appropriate size of suture for the catheter  fixation

Tegaderm dressing or custom dressing for the CVP

Colour coding used in the CVP

Yellow color – CVP monitoring

Red color

White color

Blue color

Contraindications

Inflammation of the skin at the site of puncture anatomical anomaly

Very severe pulmonary emphysema

Postoperative changes in the site area

Risks

Hematoma at the site of puncture

Catheter sepsis

Pneumothorax or chylothorax

Haemothorax

Infusion hydrothorax

Incorrect catheter positions

Cardiac arrhythmias due to the incorrect intracardiac placement of the catheter

Arterial rupture

Endocarditis due to mechanical irritation

Arterial injuries due to incorrect puncture

Catheter-induced thrombosis

Thromboembolism

Thrombophlebitis of superior vena cava

Thoracic duct injuries

Damage to brachial plexus

Damage to the phrenic nerve

Warning

Do not reuse the single-use materials

Use strictly aseptic precaution & techniques for the CVP.

Use the position of the patients in Trendelenburg

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