Subclavian Central Lines

[2win]

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So far nobody - I can be wrong though - said anything about the supraclavicular approach......
Easy, piece of cake...

 

[Planktonmd]

So far nobody - I can be wrong though - said anything about the supraclavicular approach......
Easy, piece of cake...

And requires you to aim your needle straight at the the lung too!

 

[2win]

And requires you to aim your needle straight at the the lung too!

Yes Plank - but the rate of pneumothorax is lower compared with the infraclavicular approach...At least this is what I remember.

 

[dhb]

So far nobody - I can be wrong though - said anything about the supraclavicular approach......
Easy, piece of cake...

A good description here: http://journals.lww.com/anesthesiol...avicular_Approach_Is_an_Easy_and_Safe.19.aspx

 

[2win]

A good description here: http://journals.lww.com/anesthesiol...avicular_Approach_Is_an_Easy_and_Safe.19.aspx

Thank you dhb.
In my experience this procedure is really easy.
For a normal size person you shouldn't go more than 2 inch deep to find the vein. If you don't find it - means that the site of entry is wrong. Followinf this advice the chances of pneumothorax are 0...
This isn't a procedure to be done with US guidance...There isn't really to much space to place a probe and to control the needle in the same time.
The angle of approach is important too.

 

[Planktonmd]

It is a good technique to know and could be specifically helpful when you can't get an IJ and you don't have access to do a traditional subclavian approach (intra-operatively for example).
It's still too close to the lung and too close to the brachial plexus IMHO.

Thank you dhb.
In my experience this procedure is really easy.
For a normal size person you shouldn't go more than 2 inch deep to find the vein. If you don't find it - means that the site of entry is wrong. Followinf this advice the chances of pneumothorax are 0...
This isn't a procedure to be done with US guidance...There isn't really to much space to place a probe and to control the needle in the same time.
The angle of approach is important too.