Internal Jugular Central Venous Catheter Placement
Date: *******
Time: *******
Indication: Hemodynamic monitoring/Intravenous access
Procedure done by: *******
Attending: ********
Consent:
>>Consent was obtained from ****** prior to the procedure. Indications, risks, and benefits were explained at length.
>>The procedure was performed emergently and the permission was implied because of the emergent nature.
Procedure Summary:
Procedure was started with handwash prior to starting sterile technique. A time out was performed verifying correct patient, procedure, site, positioning, and special equipment if applicable. Hands were washed immediately prior to the procedure. A surgical cap, mask with protective eyewear, full gown and sterile gloves were worn throughout the procedure. The patient was placed in Trendelenburg position. Left/Right chest region was prepped using chlorhexidine scrub and draped in sterile fashion using a three quarter sheet drape and sterile towels. The medial and lateral heads of the sternocleidomastoid muscle were identified as was the carotid pulse. The Internal Jugular vein was identified using the ultrasound. Anesthesia was achieved over the vein using 1% lidocaine. Using real-time out of plane guidance, the introducer needle was inserted into the Internal Jugular vein under direct ultrasound visualization. Venous blood was withdrawn. The syringe was removed and a guidewire was advanced into the introducer needle. The guidewire was visualized in the Internal Jugular Vein by ultrasound. A small incision was made at the skin surface with a scalpel and the introducer needle was exchanged for a dilator over the guidewire. After appropriate dilation was obtained, the dilator was exchanged over the wire for a central venous catheter. The wire was removed and the catheter was sutured in place. A sterile sorbaview shield was placed over the catheter at the insertion site. The patient tolerated the procedure without any hemodynamic compromise.
At time of procedure completion, all ports aspirated and flushed properly.
Post-procedure chest x-ray is ordered.
Estimated blood loss is ******
The attending Dr ****** was available throughout the procedure.
Subclavian Central Venous Catheter Placement
Date: *******
Time: *******
Indication: Hemodynamic monitoring/Intravenous access
Procedure done by: *******
Attending: ********
Consent:
>>Consent was obtained from ****** prior to the procedure. Indications, risks, and benefits were explained at length.
>>The procedure was performed emergently and the permission was implied because of the emergent nature.
Procedure Summary:
Procedure was started with handwash prior to starting sterile technique. A time out was performed verifying correct patient, procedure, site, positioning, and special equipment if applicable. Hands were washed immediately prior to the procedure. A surgical cap, mask with protective eyewear, full gown and sterile gloves were worn throughout the procedure. The patient was placed in Trendelenburg position. Left/Right chest region was prepped using chlorhexidine scrub and draped in sterile fashion using a three quarter sheet drape and sterile towels. Anesthesia was achieved with 1% lidocaine. The introducer needle was inserted approximately two centimeters lateral to and 1 cm inferior to the normal curvature of the patient's clavicle. Venous blood was withdrawn. The syringe was removed and a guidewire was advanced into the introducer needle. A small incision was made at the skin surface with a scalpel and the introducer needle was exchanged for a dilator over the guidewire. After appropriate dilation was obtained, the dilator was exchanged over the wire for a central venous catheter. The wire was removed and the catheter was sutured in place. A sterile sorbaview shield was placed over the catheter at the insertion site. The patient tolerated the procedure without any hemodynamic compromise.
At time of procedure completion, all ports aspirated and flushed properly.
Post-procedure chest x-ray is ordered.
Estimated blood loss is *******
The attending Dr ****** was available throughout the procedure.