Video of Central Venous Catheterization Procedure
Apr 10, 2023
Source: Cainiu Health
Dr. Zhang Jianbin
Introduction
Central venous catheterization is a commonly used clinical method for intravenous infusion. It usually involves puncturing and inserting a catheter into large veins such as the subclavian vein, internal jugular vein, or femoral vein. The procedure must be performed under the guidance of a physician. After the patient enters the operating room, they lie flat on the operating table. The physician then performs routine disinfection and draping below the patient's clavicle.
Central venous catheterization is one of the commonly used clinical methods for intravenous infusion. Large veins such as the subclavian vein, internal jugular vein, or femoral vein are typically selected for puncture and catheter placement. The procedure must be performed under a physician's guidance. Taking subclavian vein catheterization as an example, the specific steps are as follows:
1. After the patient enters the operating room, they lie supine on the operating table. The physician performs routine disinfection and draping of the area below the patient's clavicle.
2. The medical staff use one thumb to hold the skin just below the puncture site, while the other hand uses the thumb and index finger to grasp the injection needle, directing the needle tip downward toward the ipsilateral nipple. The needle is inserted quickly into the skin at an angle of 30–45° relative to the skin surface.
3. Local anesthetic is injected intradermally and subcutaneously with aspiration checks; then the vessel is punctured, a small amount of blood is aspirated to confirm entry, and finally the needle is withdrawn along the same insertion path.
4. The puncture needle is filled with 1–2 mL of normal saline and inserted beneath the clavicle. Once vascular access is achieved, a guidewire is advanced through the needle, after which the needle is removed.
5. The central venous catheter is threaded over the guidewire into the vein. The catheter is then secured locally to prevent dislodgement.
The puncture site should be disinfected daily and dressings changed regularly. After each infusion, the catheter lumen must be flushed and sealed with heparin to prevent thrombus formation.
