Today’s Morning Report is courtesy of Dr. Aherne:
Supraclavicular Subclavian Central Venous Access
Offers several advantages over infraclavicular approach:
- At the insertion site, the subclavian vein is closer to the skin
- Right sided approach provides a straighter path into the subclavian vein
- More accessible during CPR
- Less anatomical distortion in obese patients
- First rib protects against lung injury
Contraindications:
- Localized trauma to ipselateral side
- Coagulopathy
Insertion site:
- One cm lateral to lateral boarder of the of the clavicular head of the sternocleidomastoid muscle
- Needle approach should bisect the angle of the muscle boarder and the clavicle
Orient the bevel of the introducer needle caudally so as to facilitate downward progression
- The needle should be approximately parallel to the chest wall
Thanks Dr. Aherne!
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Jay Khadpe MD
- Editor in Chief of "The Original Kings of County"
- Assistant Professor of Emergency Medicine
- Assistant Residency Director
- SUNY Downstate / Kings County Hospital
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