Technique

Follow manufacturer's instructions. Sequence of stages during insertion is as follows:

1. Cannulation of the central vein, placement of guide wire and creation of the upper central wound.

2. Creation of lower peripheral wound, formation of subcutaneous tunnel and threading of the catheter through subcutaneous tunnel with cuff buried.

3. Placement of the vessel dilator/sheath in the central vein over the guide wire.

4. Placement of the catheter into the sheath.

5. Careful removal of the sheath whilst retaining position of catheter.

6. Suturing of the upper and lower wounds with suture around the body of the catheter close to the exit site to hold the catheter in position.

7. Manipulate catheter so tip lies in SVC above right atrium. Patency must be confirmed by easy aspiration of blood, and the catheter flushed with heparinised saline. Check position with standard PA chest radiograph.

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