Central Line placement: Subclavian Vein Approach

In this video, we have explained the #procedure of placement of #Subclavian catherization or CVP (central line) insertion in #ICU.
To learn More: ecgkid.com
_________________________________________________________________
Chapters:
0:00 | anatomical landmark for SVC
0:50 | Local Anastasia
1:35 | Insertion into subclavian vein
2:45 | Guide wire insertion
3:30 | catheter insertion
5:36 | remove guide wire
6:10 | check backflow
6:35 | suture the central line
_____________________________________________________________________
There are three probable sites for CVL insertion in an adult patient in emergency medicine. Each has its benefits and drawbacks. The internal jugular vein, femoral vein, and subclavian vein are all potential placement sites. The most direct routes to the right atrium via the superior vena cava are the right internal jugular vein and left subclavian vein. Because the femoral veins are compressible, they may be a better option for coagulopathic patients. The internal jugular vein route has a higher risk of pneumothorax than the subclavian vein technique. Ultrasound guiding can be quite beneficial in all situations and is the preferred method. When ultrasound guidance is not possible for a variety of reasons, such as the nature of the surgery, a lack of equipment, or a lack of expertise.
There are numerous reasons for putting a CVL, however the following are the most common in emergency medicine:
resuscitation with fluids (including blood products)
Drug infusions that could cause phlebitis or sclerosis otherwise (e.g., vasopressors and hyperosmolar solutions)
Monitoring of central venous pressure and insertion of a pulmonary artery catheter
venous access for emergencies (due to difficult peripheral intravenous access)
Placement of a transvenous pacing wire
Contraindications:
Disturbed local anatomy (such as from trauma), infection covering the insertion site, or thrombus within the desired vein are all contraindications. Coagulopathy, bleeding from the target vessel, suspected proximal vascular damage, and combative patients are all relative contraindications.