CVC Note.docx
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Pre-procedure diagnosis: - Need for intravenous access - sepsis Post-procedure diagnosis: - Need for intravenous access - sepsis Procedure performed: central line placement (Right IJ) Indications: - Need for intravenous access - sepsis Technique/Procedure: After consent was obtained, a time-out was completed at the patients bedside. The patient was placed in the trendelenburg position and a back roll was placed. The patients right neck was prepped and draped in standard sterile fashion. 5cc of 1% Lidocaine was infitrated for local anesthesia. Using a ultrasound the carotid artery was identified, and a compressible lumen just lateral to the artery was seen. Under ultrasound visualization an 18 gauge need was inserted into the right internal jugular vein. Return of dark, non-pulsatile blood was observed. A guidewire was placed through the needle into the vein. A small incision was made with a #10 scalpel and the sheath was exchanged for a dilator over the guidewire until appropriate dilation was obtained. Using the seldinger technique, a 3Fr 16cm triple lumen catheter was advanced over the guidewire to the 16cm mark. Blood was aspirated from all ports and all ports were flushed with 10cc of sterile saline. The catheter was secured with 2 sutures. A Biopatch and occlusive sterile dressing was applied. A STAT chest xray for placement was immediately ordered. OR Technique/Procedure: After consent was obtained, a time-out was completed at the patients bedside. The patients left groin was prepped and draped in standard sterile fashion. 5cc of 1% Lidocaine was infitrated for local anesthesia. The left femoral artery was palpated, and an 18 gauge need was inserted just medial to the pulse to cannulate the femoral vein. Return of dark, non-pulsatile blood was observed. A guidewire was placed through the needle into the vein. A small incision was made with a #10 scalpel and the sheath was exchanged for a dilator over the guidewire until appropriate dilation was obtained. Using the seldinger
Transcript of CVC Note.docx
Pre-procedure diagnosis:- Need for intravenous access- sepsisPost-procedure diagnosis:- Need for intravenous access- sepsisProcedure performed: central line placement (Right IJ)Indications:- Need for intravenous access- sepsisTechnique/Procedure:After consent was obtained, a time-out was completed at the patients bedside. The patient was placed in the trendelenburg position and a back roll was placed. The patients right neck was prepped and draped in standard sterile fashion. 5cc of 1% Lidocaine was infitrated for local anesthesia. Using a ultrasound the carotid artery was identified, and a compressible lumen just lateral to the artery was seen. Under ultrasound visualization an 18 gauge need was inserted into the right internal jugular vein. Return of dark, non-pulsatile blood was observed. A guidewire was placed through the needle into the vein. A small incision was made with a #10 scalpel and the sheath was exchanged for a dilator over the guidewire until appropriate dilation was obtained. Using the seldinger technique, a 3Fr 16cm triple lumen catheter was advanced over the guidewire to the 16cm mark. Blood was aspirated from all ports and all ports were flushed with 10cc of sterile saline. The catheter was secured with 2 sutures. A Biopatch and occlusive sterile dressing was applied. A STAT chest xray for placement was immediately ordered.
OR
Technique/Procedure:After consent was obtained, a time-out was completed at the patients bedside. The patients left groin was prepped and draped in standard sterile fashion. 5cc of 1% Lidocaine was infitrated for local anesthesia. The left femoral artery was palpated, and an 18 gauge need was inserted just medial to the pulse to cannulate the femoral vein. Return of dark, non-pulsatile blood was observed. A guidewire was placed through the needle into the vein. A small incision was made with a #10 scalpel and the sheath was exchanged for a dilator over the guidewire until appropriate dilation was obtained. Using the seldinger technique, a 3Fr 16cm triple lumen catheter was advanced over the guidewire. Blood was aspirated from all ports and all ports were flushed with 10cc of sterile saline. The catheter was secured with 2 sutures. A Biopatch and occlusive sterile dressing was applied. Implant(s): 3fr triple lumen catheterComplications: noneEstimated blood loss in ml's: 5.0Findings:catheter placed in right internal jugular veinreturn of non-pulsatile, dark blood all ports aspirated with proper blood return and flushed w/ 10cc of sterile salineDisposition: tolerated proc. wellRecommendations:STAT CXR for placement confirmation
