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Ultrasound Guided Subclavian Line Pearls
Subclavian central lines have historically been a landmark based procedure. While for years IJ and femoral central venous access had move to being primarily ultrasound guided (or entirely ultrasound guided), the subclavian line was a long standing holdout. As such, providers may be unfamiliar with some of the pearls that can facilitate performance of the procedure with ultrasound. In this post, Dr. Ben Duncan, ultrasound fellow discusses some of the ways to help make ultrasound work for you while trying to perform a subclavian line.
Grand Rounds Recap 06.16.21
This week’s Grand Rounds was kicked off by Dr. Fadlalla from Internal Medicine, who described his journey to a career in global health. Dr. Rafferty from Colorectal Surgery discussed anorectal disease in the Emergency Department. Drs. Milligan and Hall expertly led us through the diagnosis and treatment of dyspepsia. CPC featured a case of HUS from Dr. Winslow that Dr. Continenza walked us through. We finished with a review of genitourinary disease by Drs. Gawron, Hassani, Laurence, and Walsh.
Anatomy of a Procedure - Subclavian Cannulation
The subclavian central line, whether using an infraclavicular or supraclavicular approach can strike fear in the novice proceduralist. Big needles traversing near and seemingly towards a patients lung apex is not exactly a comforting vision. However, like with most procedures, a firm understanding of the anatomy at play will give the operator confidence as they approach what is a critical central venous access procedure particularly in crashing patients.