Central Lines
US Guided Internal Jugular Central Line
Central Venous Catheter Placement(US Guided IJ)
Date/Time: []
Indication: Hemodynamic monitoring/Intravenous access
Provider: Self
Location: [R/L] Neck
A time-out was completed verifying correct patient, procedure, site, positioning, and equipment. Consent obtained. The patient was placed in a dependent position appropriate for central line placement based on the vein to be cannulated. The area of the target vessel was surveyed with the ultrasound for verification of patency and appropriate caliber for cannulation. The patient’s neck was prepped and draped in sterile fashion. 1% Lidocaine was used to anesthetize the surrounding skin area. Under real-time ultrasound guidance, the needle was guided into the vessel and the guidewire advanced to approximately 25cm depth. The guide wire placement was confirmed using the ultrasound. A triple lumen 7-French catheter was introduced into the the vessel using the Seldinger technique. The catheter was threaded smoothly over the guide wire and appropriate, dark, non-pulsatile, blood return was obtained. Each lumen of the catheter was evacuated of air and flushed with sterile saline. The catheter was then sutured in place to the skin and a sterile dressing applied. The patient tolerated the procedure well and there were no complications. Post-procedural chest X-ray demonstrated appropriate line placement with no evidence of pneumothorax.
Estimated Blood Loss: 5mL
Total Time for Procedure: 15min
US Guided Femoral Central Line
Central Venous Catheter Placement(US Guided Femoral)
Date/Time: []
Indication: Hemodynamic monitoring/Intravenous access
Provider: Self
Location: [R/L] Groin
A time-out was completed verifying correct patient, procedure, site, positioning, and equipment. Consent obtained. The patient was placed in a dependent position appropriate for central line placement based on the vein to be cannulated. The area of the target vessel was surveyed with the ultrasound for verification of patency and appropriate caliber for cannulation. The patient’s groin was prepped and draped in sterile fashion. 1% Lidocaine was used to anesthetize the surrounding skin area. Under real-time ultrasound guidance, the needle was guided into the vessel and the guidewire advanced to approximately 25cm depth. The guide wire placement was confirmed using the ultrasound. A triple lumen 7-French catheter was introduced into the vessel using the Seldinger technique. The catheter was threaded smoothly over the guide wire and appropriate, dark, non-pulsatile, blood return was obtained. Each lumen of the catheter was evacuated of air and flushed with sterile saline. The catheter was then sutured in place to the skin and a sterile dressing applied. The patient tolerated the procedure well and there were no complications.
Blind Femoral Central Line
Central Venous Catheter Placement(Blind Femoral)
Date/Time: []
Indication: Hemodynamic monitoring/Intravenous access
Provider: Self
Location: [R/L] Groin
A time-out was completed verifying correct patient, procedure, site, positioning, and equipment. Consent was obtained. The patient was placed in a dependent position appropriate for central line placement based on the vein to be cannulated. The patient’s groin was prepped and draped in sterile fashion. 1% Lidocaine was used to anesthetize the surrounding skin area. Using palpation and landmarks, the expected area of the femoral vein was identified. The needle was introduced under constant aspiration until dark, non-pulsatile blood return was noted. A triple lumen 7-French catheter was introduced into the the vessel using the Seldinger technique. The catheter was threaded smoothly over the guide wire and appropriate, dark, non-pulsatile, blood return was again obtained. Each lumen of the catheter was evacuated of air and flushed with sterile saline. The catheter was then sutured in place to the skin and a sterile dressing applied. The patient tolerated the procedure well and there were no complications.
Estimated Blood Loss: 5mL
Total Time for Procedure: 10min
Blind Subclavian Central Line
Central Venous Catheter Placement(Blind Subclavian)
Date/Time: []
Indication: Hemodynamic monitoring/Intravenous access
Provider: Self
Location: [R/L] Upper Chest
A time-out was completed verifying correct patient, procedure, site, positioning, and equipment. Consent was obtained. The patient was placed in a dependent position appropriate for central line placement based on the vein to be cannulated. The patient’s upper chest was prepped and draped in sterile fashion. 1% Lidocaine was used to anesthetize the surrounding skin area. The needle was introduced under constant aspiration just lateral to the mid clavicle and advanced until dark, non-pulsatile blood return was noted. A triple lumen 7-French catheter was introduced into the the vessel using the Seldinger technique. The catheter was threaded smoothly over the guide wire and appropriate, dark, non-pulsatile, blood return was again obtained. Each lumen of the catheter was evacuated of air and flushed with sterile saline. The catheter was then sutured in place to the skin and a sterile dressing applied. The patient tolerated the procedure well and there were no complications. Post-procedural chest X-ray demonstrated appropriate line placement with no evidence of pneumothorax.
Estimated Blood Loss: 5mL
Total Time for Procedure: 10min
Crash Blind Central Line
Central Venous Catheter Placement(Emergent, Non-sterile, Blind [Femoral/Subclavian])
Date/Time: []
Indication: Hemodynamic monitoring, Emergent vascular access
Provider: Self
Location: [R/L] [Groin/Upper Chest]
Given the patient’s rapidly deteriorating hemodynamic status, a non-sterile central line was placed. Emergency consent invoked. Using palpation and landmarks, the expected area of the femoral vein was identified. The needle was introduced under constant aspiration until dark, non-pulsatile blood return was noted. A triple lumen 7-French catheter was introduced into the the vessel using the Seldinger technique. The catheter was threaded smoothly over the guide wire and appropriate, dark, non-pulsatile, blood return was again obtained. Each lumen of the catheter was evacuated of air and flushed with sterile saline. The catheter was then sutured in place to the skin and a dressing applied.
Estimated Blood Loss: 5mL
Total Time for Procedure: 5min
- Last updated January 20, 2023
Charting Tips
- This note includes the use of US for guidance and is made for the standard 7-Fr triple lumen. Obviously edit as needed.
- In order to bill for the US guidance portion, images must be saved to the chart. Many facilities do not have this capability.