PROCEDURE: Tunneled Hickman catheter placement
DATE:
CLINICAL INDICATION:
OPERATING PHYSICIANS: John Doe, MD (Attending)/Jane Doe, MD (Fellow)
MEDICATIONS:
ACCESS: ____vein with ultrasound guidance
CONTRAST: None
FLUOROSCOPY TIME: minutes
COMPLICATIONS: None
IMPLANTABLE DEVICE: 9 French ___ lumen Hickman catheter, lot #
PROCEDURE: The risks and benefits of the procedure and of conscious sedation were explained to the____, and informed consent was obtained. The patient’s ____neck and upper chest were prepped and draped in standard sterile fashion. The skin and subcutaneous tissues were infiltrated with 2% Lidocaine with epinephrine. Under sonographic guidance, the internal jugular vein was successfully accessed with a micropuncture needle. A 0.018″ guidewire was advanced centrally and the needle was removed. A 5 French transitional catheter was advanced over the guidewire. The wire and inner dilator were removed and a 0.035″ ____guidewire was advanced into the IVC and locked with a flow switch. The 0.018″ guidewire was used to measure the intravascular length prior to removal.
2% Lidocaine with epinephrine were infiltrated along a 10-12 cm tract along the upper chest wall. A second dermatotomy was made. The tunneling tool was passed and the catheter was pulled through and cut to length. The transitional catheter was removed and a 10 French peel-away sheath was placed over the guidewire. The dilator and wire were removed, and the catheter was advanced through the peel-away sheath and positioned centrally using fluoroscopy. The catheter was secured in place with 2-0 Ethilon. The venotomy site was closed with Dermabond and Steri-Strips The patient tolerated the procedure well and remained in stable condition throughout the stay in the angiography suite. The catheter ports were flushed and heparinized per protocol. A sterile dressing was applied.
FINDINGS:
- The ___vein is patent by sonography. Needle position was confirmed and an image was saved and stored to PACs.
- Catheter tip is in the right atrium.
IMPRESSION: Successful placement of a ____approach ___ lumen tunneled Hickman catheter as describe above.
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