Views:1 Author:Site Editor Publish Time: 2021-08-20 Origin:Site
The choice of central venous catheter placement depends on the doctor's personal habits, proficiency and puncture instruments. The main routes are internal jugular vein, subclavian vein and femoral vein. The selection of internal jugular vein puncture and catheterization can be marked by sternocleidomastoid muscle, which can be divided into three methods: anterior, middle and posterior approach. When subclavian vein catheterization is selected, the clavicle can be used as a sign and divided into upper and lower approaches. If necessary, femoral vein puncture and catheterization can also be selected at the two transverse fingers under the inguinal ligament.
The recent complications of central venous catheterization mainly include infection, accidental injury to artery, pneumothorax, etc, Especially in subclavian vein and internal jugular vein puncture, We should pay attention to the occurrence of pneumothorax, and the incidence of accidental injury to the artery during femoral vein puncture and catheterization is relatively high.
Because there are many complications of central venous catheterization, some of which are quite serious, the following points should be paid attention to when central venous catheterization: (1) be familiar with local anatomical characteristics, skilled operation skills, strict aseptic operation procedures and nursing routines（ 2) Appropriate sedation and analgesia shall be given to patients who are restless and awake without cooperation（ 3) If repeated puncture fails for 3 times, it should not be repeated, otherwise the complications will increase exponentially（ 4) Central venous catheterization should be cautious in patients with poor coagulation mechanism（ 5) According to the special nature and requirements of the patient's age, constitution, condition and purpose of catheterization, the optimal way of catheterization was selected（ 6) For some high-risk patients or those with difficult puncture, the application of ultrasound Doppler guided central venous puncture and catheterization can significantly improve the success rate of puncture and reduce the incidence of complications（ 7) Be familiar with the prevention and treatment of various complications of central venous catheterization.