Surgical & Medical Procedures Reference Training

Central Venous Catheterization: Subclavian Approach

Please select only one answer for each question.
Question - Which of the following are characteristics of a sheath introducer catheter?
Which of the following are characteristics of a sheath introducer catheter?
a.		It has three lumens to allow simultaneous infusion of fluids and measurement of central venous pressure.
b.		The sheath is designed to accept transvenous pacemakers and pulmonary artery catheters.
c.		It is not possible to infuse large volumes of fluid rapidly.
d.		The sheath introducer catheter is preferred over a triple-lumen catheter.

Question - Which of the following is FALSE regarding iatrogenic pneumothorax resulting from placement of a subclavian catheter?
Which of the following is FALSE regarding iatrogenic pneumothorax resulting from placement of a subclavian catheter?
a.		Pneumothorax is an uncommon but life-threatening complication of line placement.
b.		The risk for pneumothorax is higher with cannulation of the internal jugular vein than with the subclavian vein.
c.		Maintaining a shallow angle during needle insertion can reduce the risk for pneumothorax with subclavian vein insertion.
d.		Symptoms of iatrogenic pneumothorax include dyspnea and hyperresonance on the same side.

Question - What should be done routinely after central line placement?
What should be done routinely after central line placement?
a.		Chest radiography to verify line placement.
b.		The occlusive dressing should be left alone until the line is changed to avoid dislodging the line.
c.		The central line should be changed to a new position periodically to reduce the risk for infection.
d.		Prophylactic antibiotics are useful to reduce the risk for infection.

Question - Which patient might benefit from a central line?
Which patient might benefit from a central line?
a.		A young patient with pneumonia who has a patent 18-gauge peripheral line in place.
b.		A stable patient undergoing evaluation for cardiac output.
c.		A patient in chronic renal failure who needs access for long-term dialysis.
d.		A patient requiring treatment with a chemotherapy agent.

Question - What are some disadvantages of using the subclavian approach for a central venous catheter?
What are some disadvantages of using the subclavian approach for a central venous catheter?
a.		There is less risk for pneumothorax than with the internal jugular approach.
b.		Acute bleeding is difficult to compress if bleeding develops.
c.		The right subclavian approach has a risk of injuring the thoracic duct.
d.		The airway is likely to be threatened if a hematoma forms.