Central Venous Catheter Placement for Acute Care Skills Lab

Central venous catheter (CVC) placement is indicated in patients who need hemodynamic/fluid balance monitoring, rapid volume resuscitation, therapies such as vasoactive drugs, vasopressors and hypertonic saline and in patients with difficult venous access. A large bore catheter is placed into a large vein in the neck in which the unexposed portion lies in the superior vena cava (SVC). For this experience CVC placement location is through the subclavian approach using sonography guidance.

The basic concept is that a tube is placed below the skin and is connected to a primary vein. The exposed portion of the tube contains a valve that can open and close. When open, the valve provides medical personnel with direct access to the vein, allowing for a variety of medical procedures to be performed. When closed, the valve forms an airtight seal which prevents germs or dirt from entering the tube and causing infection or other complications. Complications of CVC placement include infection, hematoma, pneumothorax, hemothorax, thrombosis and inadvertent arterial puncture.

With a procedure as invasive as a central line, infection is perhaps the most common complication likely to occur. Not only from germs entering through the tube itself, but also from around the point of insertion. As a result, the insertion area needs to be meticulously cleaned and cared for. This protocol covers the task of central venous catheter placement by a healthcare provider.

 

Watch the video below to see how this procedure is done using VR:

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