Umbilical Vein Catheterization

imagesTo provide rapid vascular access in neonates up to 2 weeks of age for resuscitation in which all other access attempts have failed


imagesTo provide rapid administration of intravenous fluids, medications, and blood


CONTRAINDICATIONS



imagesNone for the unstable newborn with respiratory failure or cardiovascular compromise


imagesRelative Contraindications


   imagesSuccessful peripheral or central venous access


   imagesUmbilical vein catheter (UVC) placement in newborns with omphalocele, gastroschisis, omphalitis, peritonitis, or necrotizing enterocolitis


   imagesCellulitis or impetigo of the abdominal skin


LANDMARKS



imagesThe umbilicus consists of one large, thin-walled vein and two smaller, thick-walled arteries


imagesPicture the vessels as a face in which the arteries form the eyes, and the vein forms the mouth (FIGURE 91.1)


EQUIPMENT



imagesPersonal protective equipment (face mask, eye protection, gown, sterile gloves)


imagesCardiac monitor with pulse oximetry


imagesAntiseptic prep solution, sterile drapes, gauze pads, antibiotic ointment


imagesExternal heat source (i.e., radiant warmer or heat lamps)


imagesUmbilical catheter tray (if not available, then equipment listed below)


   imagesScalpel (No. 11 or 15)


   imagesSmall hemostat


   imagesNeedle holder


   imagesUmbilical tape or silk suture (3-0 or 4-0) on straight or curved needle


   imagesSize 5-French umbilical catheter


imagesA 10-mL saline-filled syringe


imagesThree-way stopcock


imagesBag of saline solution


imagesAdhesive tape



imagesGeneral Basic Steps


   imagesPrepare catheter


   imagesTie umbilicus


   imagesCut cord


   imagesIdentify vessels


   imagesPass catheter


   imagesConfirm placement


   imagesSecure catheter

Only gold members can continue reading. Log In or Register to continue

Aug 9, 2016 | Posted by in EMERGENCY MEDICINE | Comments Off on Umbilical Vein Catheterization
Premium Wordpress Themes by UFO Themes