Tunneled Hickman catheter placement Technique and Dictation

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: 

1. The  ___vein is patent by sonography. Needle position was confirmed and an image was saved and stored to PACs.
2. Catheter tip is in the right atrium.

IMPRESSION:  Successful placement of a  ____approach  ___ lumen tunneled Hickman catheter as describe above.