Download Central Line placement: Femoral - ASTEC Lab

Procedural Skills for Medical Students
Central Line placement: Femoral
Objectives:
1. Learners should be able to verbalize the indications and
contraindications of central line placement.
2. Learners should be able to verbalize the ideal
anatomical location for placement of a femoral central
line.
3. Learners should be able to insert a femoral central line
on central line trainer, using sterile technique.
Material to review prior to lab: Video on Femoral Venous
Catheter (need access to New England Journal of Medicine, available to students through
the University of Arizona Health Sciences Library)
Indications:
1. Venous access in obese or debilitated patients who have peripheral veins that are
inaccessible for peripheral IV cannulation.
2. Emergency venous access after a cardiac arrest
3. Administration of cardiac medication during cardiopulmonary resuscitation
4. Large-volume parenteral fluid administration when peripheral IV cannulation is not
readily obtainable
5. Central venous pressure monitoring
6. Administration of certain chemotherapeutic agents, vasopressor medications, or
hyperosmolar infusions (i.e. total parenteral nutrition)
7. Performance of right cardiac catheterization and pulmonary angiography
8. Performance of hemodialysis or plasmapheresis
Contraindications:
1.
2.
3.
4.
5.
6.
7.
Patient refusal
Distortion of local anatomy or landmarks
Superior vena cava syndrome
Uncontrolled coagulopathy
Burn or cellulitis over insertion site
Venous thrombosis of the proposed site
Right-sided endocarditis or mural thrombus
Equipment: HPS, central line kit, femoral central line trainer
Instructional Procedure & Endpoints:
1. Learners will be oriented to trainer and equipment in ASTEC.
2. ASTEC staff or facilitator will demonstrate instruction on proper sterile technique for
insertion of femoral central venous line.
3. Learners will demonstrate one femoral central line insertion on trainer using sterile
technique with guidance from ASTEC staff.
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Procedural Skills for Medical Students
References:
James, D. (2011). Central venous catheter insertion. In J.L. Pfenninger, & G.C. Fowler (Eds.),
Procedures for Primary Care, 3rd Ed (1443-1450). Philadelphia: Elsevier Mosby.
Tsui, J.Y., Collins, A.B., White, D.W., Lai, J., & Tabas, J.A. (2008). Placement of a femoral
venous catheter. The New England Journal of Medicine, 358(e30). Retrieved from
http://www.nejm.org/doi/full/10.1056/NEJMvcm0801006#figure=preview.gif
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