Sheath introducer - Revision history

Elcatracho: /* External Links */

2021-04-24T15:04:58Z

External Links

← Older revision		Revision as of 15:04, 24 April 2021
Line 79:		Line 79:

	==External Links==		==External Links==
	[https://etmcourse.com/large-bore-vascular-access-devices/ ETM Course: Large Bore Vascular Access Devices]		*[https://etmcourse.com/large-bore-vascular-access-devices/ ETM Course: Large Bore Vascular Access Devices]

	==References==		==References==

2021-04-24T14:44:41Z

Complications

← Older revision		Revision as of 14:44, 24 April 2021
Line 70:		Line 70:
	*Catheter related infection [[EBQ:3SITES Trial\|(historically more with femoral)]]		*Catheter related infection [[EBQ:3SITES Trial\|(historically more with femoral)]]
	*Catheter induced thrombosis		*Catheter induced thrombosis
	*Arrhythmia (usually from guidewire insertion)		*[[Arrhythmia]] (usually from guidewire insertion)
	*Venous air embolism (avoid with Trendelenburg position)		*Venous air embolism (avoid with Trendelenburg position)
	**Theoretically higher risk with sheath introducer compared to other CVC's		**Theoretically higher risk with sheath introducer compared to other CVC's

2021-04-24T14:44:13Z

Complications

← Older revision		Revision as of 14:44, 24 April 2021
Line 63:		Line 63:
	==Complications==		==Complications==
	''Complications vary by site''		''Complications vary by site''
	*Pneumothorax (more common with subclavian)		*[[Pneumothorax]] (more common with subclavian)
	*Arterial puncture (more common with femoral)		*Arterial puncture (more common with femoral)
	*Catheter malposition		*Catheter malposition
	*Subcutaneous hematoma		*Subcutaneous hematoma
	*Hemothorax		*[[Hemothorax]]
	*Catheter related infection [[EBQ:3SITES Trial\|(historically more with femoral)]]		*Catheter related infection [[EBQ:3SITES Trial\|(historically more with femoral)]]
	*Catheter induced thrombosis		*Catheter induced thrombosis

2021-04-24T14:30:30Z

Contraindications

← Older revision		Revision as of 14:30, 24 April 2021
Line 17:		Line 17:

	==Contraindications==		==Contraindications==
			===Absolute<ref>Graham, A.S., et al. Central Venous Catheterization. N Engl J Med 2007;356:e21</ref>===
			*Infection over the placement site
			*Anatomic obstruction (thrombosis of target vein, other anatomic variance)
			*Site-specific
			**Subclavian - trauma/fracture to ipsilateral clavicle or proximal ribs

			===Relative===
			*Coagulopathy (see below)
			**Of higher concern compared to triple-lumen catheters given large-bore nature of sheath introducer
			*Distortion of landmarks by trauma or congenital anomalies
			*Prior vessel injury or procedures
			*Morbid obesity
			*Uncooperative/combative patient

			{{Central line with coagulopathy}}

	==Equipment Needed==		==Equipment Needed==

2021-04-24T14:28:44Z

Equipment Needed

@@ Line 20: / Line 20: @@
 ==Equipment Needed==
+*Kit typically contains:
 ==Procedure==

2021-04-24T14:26:50Z

Procedure

← Older revision		Revision as of 14:26, 24 April 2021
Line 23:		Line 23:

	==Procedure==		==Procedure==
			''Same procedure as [[central line]] placement according to site (see below) however the dilator must be pre-loaded into the line and the dilator-sheath is introduced over the wire simultaneously. Afterwards, the dilator and wire are removed together.''
			**[[Central line: internal jugular]]
			**[[Central line: subclavian]]
			**[[Central line: supraclavicular]]
			**[[Central line: femoral]]

	==Complications==		==Complications==

2021-04-19T04:04:12Z

Indications

← Older revision		Revision as of 04:04, 19 April 2021
Line 13:		Line 13:
	*Repetitive blood sampling		*Repetitive blood sampling
	*Administering hyperalimentation, vasopressors, caustic agents, or other concentrated fluids		*Administering hyperalimentation, vasopressors, caustic agents, or other concentrated fluids
			*Insertion of [[pulmonary artery catheters]]
	*Insertion of transvenous cardiac pacemakers		*Insertion of transvenous cardiac pacemakers

2021-02-07T20:05:07Z

2021-02-05T18:38:38Z

References

2021-02-05T18:38:03Z

References

@@ Line 39: / Line 39: @@
 ==See Also==
-===[[Vascular access|Vascular access types]]===
+{{Template:Vascular access types}}
 ==External Links==