![]() ![]() A guide wire is then passed through the needle until it is appropriately positioned within the vessel. First, the target vessel is cannulated with an 18-gauge thin-walled needle. In the case of CVC insertion, the device is an intravascular catheter and the target vessel is a central vein. Seldinger technique is the introduction of a device into the body over a guide wire, which is placed through a thin-walled needle. Successful placement of a femoral CVC requires working understanding of the target anatomy, access to with procedural ultrasound, and fluidity in the Seldinger technique. In addition, cannulation of the femoral artery allows one to simultaneously perform other procedures needed for stabilization, such as cardiopulmonary resuscitation (CPR) and intubation. Each of these vessels has distinct advantages and disadvantages with unique anatomical considerations.įemoral vein cannulation can be easily performed both under ultrasound guidance and using the surface landmarks therefore, femoral access is often used when emergent placement of a central venous catheter (CVC) is needed (such as in the case of medical codes and trauma resuscitations). There are three veins in the body that are accessed for central venous cannulation: the internal jugular, the subclavian, and the femoral. ![]() Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USAĬentral venous access is necessary in a multitude of clinical situations, including vascular access, vasopressor and caustic medication delivery, central venous pressure monitoring, volume resuscitation, total parental nutrition, hemodialysis, and frequent phlebotomy. ![]()
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