Emergent Umbilical Venous Catheter (UVC) Placement

In a sick neonate where peripheral venous access is not possible, placement of an umbilical venous catheter (UVC) may be lifesaving!
The umbilical vein may remain patent for up to 10 days after birth.

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http://www.uichildrens.org/insertion-of-umbilical-vessel-catheters/

Indication:

  • Emergency resuscitation and stabilization of neonates (to give volume or medications, such as epinephrine

Contraindications:

  • Abdomen doesn’t look normal (omphalocele, gastroschisis, omphalitis, peritonitis, necrotizing enterocolitis)
  • Vascular compromise of the lower limbs

 

Umbilical Vessel Anatomy:

Neonatal Anatomy

From Robert and Hedge’s Clinical Procedures in Emergency Medicine

  • Umbilical cord has 2 arteries and 1 vein
    • Vein is thin-walled, usually at 12 o’clock
    • Arteries are smaller and thick-walled
  • Neonatal blood flow:
    • Umbilical vein –> ductus venosus –> IVC –> RA –> PA –> ductus arteriosus –> aortic arch
    • Umbilical arteries –> internal iliac arteries

 

Finding your Materials:

  • In Hasbro ED:
    • Locate UVC Tray and UVC lines in Hasbro Trauma Bay
    • Other materials not in kit:
      • 3-0 silk suture on a curved needle
      • Infusion solution (usually NS or D10W)
      • Three-way stopcock
      • Tegaderm and tape

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