Pre-Procedure Diagnosis: Need for central venous access for administration of medication.

Post-Procedure Diagnosis: Successful placement of central venous catheter.

Procedure Performed: Insertion of a non-tunneled central venous catheter through the right internal jugular vein into the superior vena cava.

Preparation:

• The patient was positioned supine with the head turned slightly to the left.
• The right internal jugular area was prepped and draped in a sterile fashion.
• Local anesthesia with 1% lidocaine was administered to the insertion site.

Procedure Details:

1. Using sterile technique, the right internal jugular vein was identified using ultrasound guidance.
2. The vein was punctured with an 18-gauge introducer needle.
3. A guidewire was then advanced through the needle into the vein, and the needle was removed.
4. A small skin incision was made at the insertion site.
5. A dilator was passed over the guidewire to dilate the subcutaneous tissue and vein.
6. The dilator was removed, and the central venous catheter was advanced over the guidewire into the superior vena cava.
7. The guidewire was removed, and proper catheter placement was confirmed by aspiration of blood from all ports and flushing with saline.
8. The catheter was secured to the skin with sutures.
9. A sterile dressing was applied to the insertion site.

Confirmation of Placement: Placement of the catheter was confirmed by chest X-ray, showing the tip of the catheter in the superior vena cava.

Complications: No immediate complications were noted. The patient tolerated the procedure well.

Estimated Blood Loss: Minimal

Case Study 11

Alphabetic Index: Insertion of Device in > Vena Cava > Superior > 02HV

This is being used for medication administration, so "infusion device" is the correct device value.