Morning Report: Supraclavicular CVC Placement

Supraclavicular CVC Placement

• First described in 1965 as an alternative method for obtaining central venous access
• At the insertion site the subclavian vein is closer to the skin than using the infraclavicular subclavian vein approach
• Insertion sites of the needle include
  • One centimeter lateral to the lateral border of the clavicular head of the SCM and one CM superior to the clavicle
  • One centimeter medial and one centimeter superior to the midpoint of the clavicle with the needle directed towards the ipsilateral SC joint
  • Just posterior to the clavicle at the junction of middle/medial third of the clavicle
• Aspiration of air bubbles = pneumothorax = bad
  • On the bright side you’ll get to show off those amazing chest tube skills
• Is usually done without ultrasonographic assistance but U/S can be used with the probe in long axis
  • Allows for identification of subclavian artery and lung pleura

Thanks to Dr. Rolston-Cregler for today’s Morning Report!

• http://www.aliem.com/trick-of-the-trade-ultrasound-guided-supraclavicular-central-line/
• http://www.youtube.com/watch?v=I3Jqbxa1_Ts
• http://emedicine.medscape.com/article/80355-overview#showall

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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

Latest posts by Jay Khadpe MD (see all)

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