USG-guided placement of a multi-lumen catheter into the internal jugular vein for pressors, TPN, or CVP monitoring.
Indications
- • Vasopressor infusion
- • TPN
- • Poor peripheral access
- • CVP monitoring
- • Hemodialysis (temporary)
Contraindications
- ⚠ Coagulopathy (relative)
- ⚠ Overlying infection
- ⚠ Contralateral pneumothorax
Equipment
- • USG with linear probe
- • CVC kit (Seldinger)
- • Sterile drape/gown/gloves/mask/cap
- • Chlorhexidine
- • Local anesthetic
- • Sutures, occlusive dressing
Positioning
- • Supine, Trendelenburg 15°, head turned slightly to opposite side.
Consent
- • Explain indication, benefits, alternatives
- • Explain risks & complications
- • Obtain written/verbal consent as per SOP
- • Document consent
Universal precautions
- • Hand hygiene
- • PPE — gloves, mask, eye protection
- • Aseptic technique
- • Sharps safety
- • Verify patient identity & site
Step-by-step (0/8)
Tap to complete
Cap, mask, sterile gown, sterile gloves, wide drape.
Immediate complications
- ⚠ Pneumothorax
- ⚠ Arterial puncture
- ⚠ Hemothorax
- ⚠ Arrhythmia
- ⚠ Air embolism
- ⚠ Wire embolism
Delayed complications
- • CLABSI
- • Thrombosis
- • Stenosis
Recognition
- • Bright pulsatile blood
- • CXR abnormality
Initial management
- • Withdraw; pressure; chest tube if PTX
Prevention
- • USG guidance
- • Full barrier precautions
- • Daily line review
Post-procedure observation
- • Site inspection q shift
- • Dressing intact
Monitoring
- • CLABSI bundle: hand hygiene, chlorhexidine, daily review
Documentation
- • Site, lumens, depth
- • USG use
Patient instructions
- • Report fever, redness
Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.
