Central venous cannulation

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Use of ultrasound guidance to place a central venous catheter is associated with:

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Decreased success rate and increased arterial puncture rate.

Increased success rate and decreased arterial puncture rate.

Increased risk of pneumothorax

Increased overall visit and hospitalization costs.

Other:

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The transducer of choice for ultrasound guided central venous catheter placement is the ___________________ transducer.

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low frequency phased array

low frequency curvilinear

high frequency intracavitary

high frequency linear

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Scanning the neck before sterilely prepping a patient for internal jugular central venous catheter placement

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A allows the provider to select the optimal side and site for catheter placement

B allows the provider to identify possible venous thrombus and avoid venous puncture of that vein

C extends the time necessary to perform the procedure but provides little advantage

A and B

All of the above

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Using a short axis approach to ultrasound guided central venous catheter placement may be associated with increased risk of the following complication:

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arterial puncture/cannulation due to posterior wall puncture of the vein

arterial puncture/cannulation due to anterior wall puncture of the vein

venous thrombosis

compression of the vein with inadequate target vein visualization

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Using the modified short axis approach to placing a central venous catheter, if the internal jugular vein is located at a depth of 2 cm, the needle should enter the skin _____________________.

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2 cm distal to the ultrasound transducer's position on the neck and at a 45-60 degree angle

2 cm proximal to the ultrasound transducer's position on the neck and at a 45-60 degree angle

just proximal to ultrasound transducer's position on the neck and at a 45-60 degree angle

3 cm proximal to the ultrasound transducer's position on the neck and at a 45-60 degree angle

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To ensure venous rather than arterial cannulation, the following step is the most helpful prior to dilation.

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ultrasound visualization of the needle in the vein

ultrasound visualization of the guide wire in the vein

chest x-ray

observing return of dark blood rather than bright red blood in the syringe on aspiration

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