Procedures //

IJ / Internal Jugular Line Central Line Placement by Alexandra Dyer, MD: Patient consented, sterilely draped, full prep, gown, glove, mask, time out performed. Anesthesia: 1% lidocaine locally Location: [XOXOXO] Device: Multiple lumen Technique: Seldinger technique. Secured with suture. Results: Venous return from all ports with easy saline flush. No complications. Compl : None Guide wire [XOXOXO] retrieved and disposed of. [ED Procedural Ultrasound by Alexandra Dyer, MD: Central line placed by Alexandra Dyer, MD using concurrent ultrasound guidance. Real time image archived in the medical record confirms vascular anatomy.] Chest X-ray 1V Interpreted by Alexandra Dyer, MD: Central line [XOXOXO] in SVC, Normal soft tissue, No evidence of pneumothorax Procedure: IJ venous catheterization by A. Dyer, MD. The skin was widely prepped in sterile fashion with Betadine and Chloroprep. The area was then draped with a sterile drape. A total of 4 mL of 1% lidocaine wo epinephrine was infiltrated in the subcutaneous tissue at the site of anticipated needle entry. ultrasound was used to locate the vein An introducer needle was then advanced slowly into the internal jugular vein. On vascular entry, venous blood was returned and the blood flow did not appear pulsatile. A guidewire was then passed through the introducer needle. The guidewire position in the vein was confirmed with ultrasound. The needle was subsequently removed and a small stab incision was made over the wire. A dilator was then passed over the wire and removed. A central venous catheter was then inserted over the wire by Seldinger technique. The guide wire was retrieved and disposed of. Type of catheter: triple lumen 7 french The catheter was secured using sutures and a Tegaderm dressing.



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