Common Catheter Insertion Sites

• Internal Jugular Vein – located in the neck
• Femoral Vein – located in the upper thigh/groin area

1. Internal Jugular Catheter Insertion

Indication

Preferred for short- to medium-term access due to lower infection risks and better blood flow dynamics.

Procedure Steps

1. Positioning: Patient lies flat with head turned opposite to the site.
2. Anesthesia: Local anesthetic is administered.
3. Needle Insertion: Inserted at 45° angle near clavicle into the IJV.
4. Guidewire & Dilator: Guidewire placed, then dilator to widen the tract.
5. Catheter Placement: Dual-lumen catheter inserted, position confirmed via ultrasound or fluoroscopy.
6. Securing: Catheter sutured and dressed sterilely.

Potential Complications

• Pneumothorax
• Carotid artery puncture
• Infection

2. Femoral Catheter Insertion

Indication

Used when IJV access is not viable. Rapid but with higher infection risk.

Procedure Steps

1. Positioning: Patient lies flat, legs slightly apart.
2. Anesthesia: Local anesthetic is injected in groin area.
3. Needle Insertion: Femoral vein accessed with a needle.
4. Guidewire & Dilator: Inserted as above.
5. Catheter Placement: Dual-lumen catheter placed and confirmed.
6. Securing: Sterile dressing and securement.

Potential Complications

• Infection (especially in immobile patients)
• Thrombosis
• Discomfort during movement

Key Considerations

• Catheter Type: Use dual-lumen for efficient blood flow.
• Duration of Use: IJV catheters last longer; femoral for emergencies only.
• Monitoring: Ensure flow rate and catheter patency.
• Operator Skill: Expertise reduces complications.

Conclusion

Both internal jugular and femoral catheter insertions are essential emergency dialysis procedures. Proper technique, careful monitoring, and timely removal are key to minimizing risks and improving patient outcomes.