Femoral Central Venous Access Periprocedural Care

Updated: Dec 05, 2016
  • Author: Neelu Pal, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Periprocedural Care

Equipment

The basic materials required for central venous cannulation are widely available as prepackaged kits (see the image below). The components that are required to place a femoral vein catheter include the following [7] :

  • Povidone-iodine or chlorhexidine solutions to swab and prepare the venipuncture site
  • Sterile drapes and towels
  • Sterile gloves
  • Gown, mask, and cap
  • Local anesthetic (lidocaine 1%)
  • Needle, 26 gauge, with 2- to 5-mL syringe, for injecting local anesthetic
  • Needle, 26 gauge, to be used as a finder needle
  • Needle, 20-22 gauge, with 10-mL syringe, to access the femoral vein
  • Flexible guide wire with J-tip
  • No. 11 scalpel
  • Dilator device for the skin and soft tissue overlying the vein
  • Single- or multiple-lumen catheter
  • Silk or nylon sutures, 3-0 or 4-0
  • Needle holder
  • Suture scissors
  • Dressings (antibiotic ointment, gauze pads, cloth or plastic tape)
Triple-lumen catheter kit. Triple-lumen catheter kit.
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Patient Preparation

Anesthesia

Identify anatomic landmarks. Clean and prepare the proposed venipuncture site with alcohol and a povidone-iodine or chlorhexidine swab. Using a 26-gauge needle, infiltrate the skin and subcutaneous tissue over the site with 2-5 mL of lidocaine 1%. Anesthesia may be omitted in an emergency situation where venous access is required in an obtunded patient for expeditious administration of medications and fluids. For more information, see Local Anesthetic Agents, Infiltrative Administration.

Positioning

For femoral vein catheterization, the patient should be placed in the supine position with the hip in the neutral position.

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