Venous cutdown

Jump to navigation Jump to search

Template:Interventions infobox

WikiDoc Resources for Venous cutdown

Articles

Most recent articles on Venous cutdown

Most cited articles on Venous cutdown

Review articles on Venous cutdown

Articles on Venous cutdown in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Venous cutdown

Images of Venous cutdown

Photos of Venous cutdown

Podcasts & MP3s on Venous cutdown

Videos on Venous cutdown

Evidence Based Medicine

Cochrane Collaboration on Venous cutdown

Bandolier on Venous cutdown

TRIP on Venous cutdown

Clinical Trials

Ongoing Trials on Venous cutdown at Clinical Trials.gov

Trial results on Venous cutdown

Clinical Trials on Venous cutdown at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Venous cutdown

NICE Guidance on Venous cutdown

NHS PRODIGY Guidance

FDA on Venous cutdown

CDC on Venous cutdown

Books

Books on Venous cutdown

News

Venous cutdown in the news

Be alerted to news on Venous cutdown

News trends on Venous cutdown

Commentary

Blogs on Venous cutdown

Definitions

Definitions of Venous cutdown

Patient Resources / Community

Patient resources on Venous cutdown

Discussion groups on Venous cutdown

Patient Handouts on Venous cutdown

Directions to Hospitals Treating Venous cutdown

Risk calculators and risk factors for Venous cutdown

Healthcare Provider Resources

Symptoms of Venous cutdown

Causes & Risk Factors for Venous cutdown

Diagnostic studies for Venous cutdown

Treatment of Venous cutdown

Continuing Medical Education (CME)

CME Programs on Venous cutdown

International

Venous cutdown en Espanol

Venous cutdown en Francais

Business

Venous cutdown in the Marketplace

Patents on Venous cutdown

Experimental / Informatics

List of terms related to Venous cutdown


Overview

Venous cutdown is an emergency procedure to get vascular access, in which the vein is exposed surgically and then a cannula is inserted into the vein under direct vision. It is used in trauma and hypovolemic shock, when peripheral cannulation is difficult or impossible. The saphenous vein is commonly used, but antecubital and femoral vessels are also suitable. Complications of venous cutdown include cellulitis, hematoma, phlebitis, perforation of the posterior wall of the vein, venous thrombosis and nerve and arterial transection.

  • 1. Prepare the skin of the ankle with antiseptic solution and drape the area
  • 2. Infiltrate the skin if time permits
  • 3. Identify the surface anatomy of the greater saphenous vein: 2 cm anterior and superior of the medial malleolus. Perform a full-thickness transverse skin incision of 2,5 cm
  • 4. Identify the vein with blunt dissection and dissect it free from the accompanying structures.
  • 5. Elevate and dissect the vein for a distance of approximately 2-cm, to free it from its bed.
  • 6. Ligate the distal, mobilized vein, leaving the suture in place for traction
  • 7. Pass a tie about the vein more proximally
  • 8. Make a small transverse incision (venotomy) and gently dilate the venotomy with the tip of a closed hemostat.
  • 9. Introduce a cannula through the venotomy and secure it in place by tying the upper ligature about the vein and cannula. The cannula should be inserted an adequate distance to prevent dislodging.
  • 10. Attach the intravenous line to the cannula.

References

  • McIntosh B, Dulchavsky S (1992). "Peripheral vascular cutdown". Crit Care Clin. 8 (4): 807–18. PMID 1393752.

External links

Template:Vascular surgery procedures

Template:Jb1 Template:WH Template:WikiDoc Sources