1. Central Venous Catheter
2. Guidewire with advancer
4. Introducer needle
5. Tissue dilator
6. Injection cap
7. Injection needle
Raw and Slight
Possible and Fatal
One week, additional care needed after one week
Supine position(except heart failure and difficult breathing)
Head Down Position
Head Down Position
Head Moving is limited
Good blood flow rate, depend on the position of insertion.
Good Blood Flow Rate
Good blood flow rate
Blood Flow and Difficulty
Lack of long term observation, used for short term. Embolism's
possibility is low.
Embolism's Possiblity is high. Operation is un easy
Embolism's possibility is low. Operation is easy.
1) Place the patient in a trendelenberg position (15 to 30 degrees
head down) to reduce the chance of an air embolism, turn the
patient’s head to the side contralateral to the site chosen.
2) mark puncture site
3) Anesthetize the spot by using needle, the angle between needle
and skin shall be 30 to 45 degrees.
4) when a flush of blood returns by advancing the needle, insert
Remarks: pay attention to the direction of needle and color of
returns during advancing seeker needle , meanwhile, pay attention
the direction of needle and depth of puncturing needle , the bevel
needle shall be faceup.
5) one hand hold the needle,another hand hold the syringe ,keep the
pressure negative during the slow insertion. When you feel the
needle placed into the vein, the blood will return smoothly.
6) Guidewire will be inserted through Y shaped syringe or hollow
Remarks: during the insertion of guidewire,please judge the
resistence , don’t withdraw
the guidewire by force, withdraw the guidewire together with
syringe if ncessary.
7) withdraw syringe, and insert dilator by 1-2 cm under the skin
for enlarge the track.
Remarks: During insertion of dilator, attention shall be paid to
the direction and the force of dilator, specially the force
transfering between dilator and guidewire, the driving force shall
be increased gradually.
Withdraw the dilator, implant the catheter from the end of
guidewire, and saline shall be injected into to the catheter
Ensure the whole catheter implanted completely and then fixed the
catheter at the final position.
Connect with other tubes and devices
The force for inserting the catheter is related to enlarging of the
track, if the resistence is big, the length of each insertion shall
be shorter , and attetion shall be paid to avoid kink of guidewire.