<br />
Ultrasound-guided central venous<br />
catheterization<br />
Philips tutorial<br />
Michael B. Stone, MD, RDMS<br />
Department of Emergency Medicine<br />
Alameda County Medical Center –<br />
Highland General Hospital<br />
Arun Nagdev, MD<br />
Department of Emergency Medicine<br />
Alameda County Medical Center –<br />
Highland General Hospital<br />
Table of contents<br />
Ultrasound-guided central venous catheterization<br />
1 Introduction .......................................................................................................................................... 3<br />
2 Clinical case ......................................................................................................................................... 4<br />
3 Anatomy................................................................................................................................................... 5<br />
4 Ultrasound techniques .......................<a title="Ultrasound-Guided Central Venous Catheterization page 1" href="http://viewer.zmags.com/publication/6b08916c?page=1"> Ultrasound-guided central venous catheterization </a>
<a title="Ultrasound-Guided Central Venous Catheterization page 2" href="http://viewer.zmags.com/publication/6b08916c?page=2"> Table of contents Ultrasound-guided central ven</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 3" href="http://viewer.zmags.com/publication/6b08916c?page=3"> 1 Introduction Central venous catheterization (</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 4" href="http://viewer.zmags.com/publication/6b08916c?page=4"> 2 Clinical case A 74 year old female with a pas</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 5" href="http://viewer.zmags.com/publication/6b08916c?page=5"> 3 Anatomy The internal jugular vein is a direct</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 6" href="http://viewer.zmags.com/publication/6b08916c?page=6"> 3 Anatomy The position of the internal jugular </a>
<a title="Ultrasound-Guided Central Venous Catheterization page 7" href="http://viewer.zmags.com/publication/6b08916c?page=7"> Depending on individual anatomic variation, patie</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 8" href="http://viewer.zmags.com/publication/6b08916c?page=8"> 3 Anatomy In addition, the internal jugular vei</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 9" href="http://viewer.zmags.com/publication/6b08916c?page=9"> 9</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 10" href="http://viewer.zmags.com/publication/6b08916c?page=10"> 3 Anatomy </a>
<a title="Ultrasound-Guided Central Venous Catheterization page 11" href="http://viewer.zmags.com/publication/6b08916c?page=11"> The right internal jugular vein is generally pref</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 12" href="http://viewer.zmags.com/publication/6b08916c?page=12"> 4 Ultrasound technique Ensure that the ultrasou</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 13" href="http://viewer.zmags.com/publication/6b08916c?page=13"> Most physicians use a high-frequency linear trans</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 14" href="http://viewer.zmags.com/publication/6b08916c?page=14"> 4 Ultrasound technique </a>
<a title="Ultrasound-Guided Central Venous Catheterization page 15" href="http://viewer.zmags.com/publication/6b08916c?page=15"> Based on this screening exam, choose the side and</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 16" href="http://viewer.zmags.com/publication/6b08916c?page=16"> 4 Ultrasound technique </a>
<a title="Ultrasound-Guided Central Venous Catheterization page 17" href="http://viewer.zmags.com/publication/6b08916c?page=17"> 17</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 18" href="http://viewer.zmags.com/publication/6b08916c?page=18"> 4 Ultrasound technique Although an assistant ca</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 19" href="http://viewer.zmags.com/publication/6b08916c?page=19"> 19</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 20" href="http://viewer.zmags.com/publication/6b08916c?page=20"> 4 Ultrasound technique However, in cases when a</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 21" href="http://viewer.zmags.com/publication/6b08916c?page=21"> 21</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 22" href="http://viewer.zmags.com/publication/6b08916c?page=22"> 4 Ultrasound technique </a>
<a title="Ultrasound-Guided Central Venous Catheterization page 23" href="http://viewer.zmags.com/publication/6b08916c?page=23"> Things to keep in mind: • The physician should be</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 24" href="http://viewer.zmags.com/publication/6b08916c?page=24"> 4 Ultrasound technique </a>
<a title="Ultrasound-Guided Central Venous Catheterization page 25" href="http://viewer.zmags.com/publication/6b08916c?page=25"> When the needle is passed correctly, the needle t</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 26" href="http://viewer.zmags.com/publication/6b08916c?page=26"> 4 Ultrasound technique </a>
<a title="Ultrasound-Guided Central Venous Catheterization page 27" href="http://viewer.zmags.com/publication/6b08916c?page=27"> When blood flashback is obtained, the guide wire </a>
<a title="Ultrasound-Guided Central Venous Catheterization page 28" href="http://viewer.zmags.com/publication/6b08916c?page=28"> 4 Ultrasound technique </a>
<a title="Ultrasound-Guided Central Venous Catheterization page 29" href="http://viewer.zmags.com/publication/6b08916c?page=29"> As stated on page 27, direct visualization of gui</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 30" href="http://viewer.zmags.com/publication/6b08916c?page=30"> 5 Clinical pearls • Examine both sides of the n</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 31" href="http://viewer.zmags.com/publication/6b08916c?page=31"> 6 Case resolution Using ultrasound guidance, th</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 32" href="http://viewer.zmags.com/publication/6b08916c?page=32"> 7 Bibliography 1. McGee DC, Gould MK. Preventin</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 33" href="http://viewer.zmags.com/publication/6b08916c?page=33"> Additional resources Additional resources relat</a>
<a title="Ultrasound-Guided Central Venous Catheterization page 34" href="http://viewer.zmags.com/publication/6b08916c?page=34"> Philips Healthcare is part of Royal Philips Elect</a>