UMEM Educational Pearls

Placement of central-lines through the subclavian (SC) route has several advantages over other sites of venous cannulation:

•    Lower rates of infection

•    Lower rates of deep vein thrombosis

Placing a central-line through the "blind" SC approach increases the risk of non-compressible vessel injury and pneumothorax as compared to other approaches (e.g. internal jugular).

Ultrasound can help place central-lines in the SC vein while reducing the risk of complications; this video demonstrates the technique: http://ultrarounds.com/Ultrarounds/Subclavian_Ultrasound.html

 

 

References

Fragou, M. et al. Real-time ultrasound-guided subclavian vein cannulation versus the landmark method in critical care patients: a prospective randomized study. Crit Care Med. 2011 Jul;39(7):1607-12.

Follow me on Twitter (@criticalcarenow) and Google+ (+haney mallemat)