a blog series on emergency medicine procedures
In the last post (the central line part 1) we focused on the indications/contraindications and anatomic considerations. Here we focus on technique and procedural steps. Enjoy.
HUNTING & GATHERING
*note: images shown in this section are institution-specific (Rhode Island Hospital Emergency Department)
Find a computer with a functioning Topaz to obtain informed consent:
Go to this corner in any critical care room (here is a closer look) and obtain a central line kit:
OR
Finally, obtain these items:
- mayo stand
- sterile gloves
- chlorhexidine scrub
- 2-3 sterile saline flushes
- non-sterile marking pen
- ultrasound machine and ultrasound probe cover
- in kit: hat, gown, facemask
PREP
PRE-STERILITY:
- Open kit and empty sterile contents onto the field
- ULTRASOUND:
- Plug in ultrasound machine. It WILL run out of battery if you don’t and the screen will shut off in the middle of the procedure
- Test your US probe orientation: tap gently on left side of probe…this should match left side of your screen
- Examine the target vein: is it compressible? Is it plump and easily visualized?
- PATIENT:
- Position the patient
- Scrub target area with chlorhexidine
- Mark the site
TIMEOUT!
…and document it:
STERILIZE.
Watch this video.
From EMCrit.org, Scott Weingart, RACC Sterile Line Preparation