Procedure: Ultrasound & fluoro guided central venous catheter           

Indication:    .   

Date:    

Operators:  Drs.    

Medications:  Local,    

Fluoro time:    

Catheter:  7 French x     cm arrow triple lumen catheter 

Access site:  Right internal jugular vein with ultrasound

Complications:  None immediate.

 

The risks, benefits, and alternatives to the procedure were explained to the patient.   Written informed consent was obtained. A timeout was performed. 

The right neck region was prepped and draped in sterile fashion. The vessels were ultrasonographically evaluated and an appropriate entry site chosen. 

Using local anesthetic and under direct ultrasound guidance, the right internal jugular vein was punctured with a 21 gauge needle. Images documenting vein patency and needle entry were saved and transferred to PACS.  A 0.018″ wire was passed centrally, and the needle exchanged for a transitional dilator.

A 0.035″ wire was advanced through the dilator and the skin tract was serially  dilated.  The 7 French triple-lumen catheter was advanced over the wire and positioned centrally using fluoroscopy.  The wire was removed and the ports were flushed, tested and heparinized per protocol. The catheter was sutured in place and an antimicrobial disc and sterile dressing were applied.

The procedure was well tolerated and the patient was discharged in satisfactory condition.

 

Findings:

  1. The right internal jugular vein is ultrasonographically patent. Needle entry was documented.
  2. The catheter tip is in the    .
  3. additional findings on image.

 

Impression: 

Uneventful image guided placement of  7 French right internal jugular triple-lumen central venous catheter as described.