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Midline access is a type of peripheral venous access inserted into peripheral veins and that extends further than standard peripheral catheters but does not yet reach the large central veins of the thorax. They are used when intermediate-term access (one month) is needed or when administering medications that are highly irritating to smaller veins.
The port access site is fixed at 5 cm below the midline of the clavicle and 9 to 10 cm lateral to the midline of the chest. Then, a 5 to 6 cm incision is made to create a subcutaneous tissue pouch for the placement of port access site. A tunnel is made from the port access site until adjacent to the internal jugular neck wound.
The femoral vein is often used to place a central venous catheter, or line for venous access. Ultrasound imaging for locating the vein and catheter placement is advocated over the use of anatomical landmarks due to the possible presence of anatomical variants. [23] [24] [25] This is associated with a significant risk of infection. [25] [26]
Venous cutdown is an emergency procedure in which the vein is exposed surgically and then a cannula is inserted into the vein under direct vision. It is used for venous access in cases of trauma , and hypovolemic shock when the use of a peripheral venous catheter is either difficult or impossible.
Implanted central venous catheter Implanted port. The "nipples" which define the clinician's target area are here readily discerned. Gripper needle inserted in port. An implanted central venous catheter, also called a port a "cath" or "port-a-cath", is similar to a tunneled catheter, but is left entirely under the skin and is accessible via a ...
Historically, IVC filters were placed surgically, but with modern filters that can be compressed into much thinner catheters, access to the venous system can be obtained via the femoral vein (the large vein in the groin), the internal jugular vein (the large vein in the neck) or the arm veins with one design.
A peripheral venous catheter is the most commonly used vascular access in medicine. It is given to most emergency department and surgical patients, and before some radiological imaging techniques using radiocontrast, for example. In the United States, in the 1990s, more than 25 million patients had a peripheral venous line each year. [2]
Venous access port catheter. Dialysis catheters include temporary and tunneled large-bore central venous access lines placed for administering hemodialysis. When possible, these catheters are placed in the right internal jugular vein, but the left internal jugular and femoral veins may also be utilized.