Central venous cannulation

Two routes are commonly used:

• internal jugular veins

• subclavian veins.

For routine placement, the preferred site is the subclavian vein (EPIC Project 2001) but during resuscitation, the internal jugular vein is often preferred (Polderman & Girbes 2002). In most cases the Seldinger technique is used (Hinds & Watson 1996):

• the vein is punctured with a needle and syringe;

• a wire is passed through the needle into the vein;

• the needle is withdrawn;

• the cannula is passed over the wire into the vein;

• the wire is removed, leaving the cannula in the vein.

Early complications of the procedure include injury during insertion, pneumothorax and air embolus (Woodrow 2002).

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