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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.
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.
Grand Rounds Recap 02.17.21
This week Dr. Koehler has great teaching points on epistaxis, PRES and more during M&M. Dr. McMullan recounts a harrowing tale of compassion in a case follow up. Dr. Wosiski-Kuhn gives a timely reminder on carbon monoxide and cyanide toxicities followed by Dr. Robleeās acidotic arrest case and Dr. Lane wraps up with some business need-to-knows of EM.