|
|
CENTRAL VENOUS CATHETERIZATION
|
Central Venous Catheterization.
|
INDICATIONS:
- Large-volume parenteral fluid administration
- Monitoring of central venous pressure
- Emergency venous access
- Administration of some medications (e.g., chemotherapy)
- Administration of hyperosmolar solutions, such as some
paraenteral nutrition formulas
- Placement of Swan-Ganz catheter
- Performance of hemodialysis or
plasmapheresis
CONTRAINDICATIONS:
- Distortion of local anatomy or landmarks (may result from surgery,
trauma, or irradiation to the area)
- For subclavian insertion, chest wall deformities (moderate to severe
with distortion in local anatomy or landmarks)
- Suspected injury to the superior vena cava
(e.g., superior vena cava
syndrome in which venous access below the diaphragm is preferable)
- Bleeding diathesis or anticoagulation therapy
- Full-thickness burn, cellulitis, or other infection over the anticipated
insertion site
- Pneumothorax or
hemothorax on the
contralateral side, or inability
to tolerate Pneumothorax on ipsilateral side
PRE- and POST-PROCEDURE PATIENT EDUCATION:
Obtain informed consent for this procedure. Inform the patient of
the possibilities of major complications and their management, which could
require chest tube placement, surgery, or cardioversion. To minimize
patient anxiety during the procedure, explain the major steps of the procedure
and the necessity of remaining in the Trendelenburg position possibly for some
time.
|
|
"Once
you see it, you will never forget it."
"Trust your photogenic memory."
|
|