Point of Care Ultrasonography Versus Standard Blind Technique for Central Venous Catheter Insertion in Emergency Hospital

Central venous catheter (CVC) - also called central venous access, central venous line, or central line - is a thin catheter that is inserted through one of the large veins in the neck area into the venous system. It ends in one of the venae cavae just before entering the right atrium.

CVC is a procedure frequently required in critical care units. Indications include patients with multiple, incompatible intravenous (IV) medications with limited peripheral access, or who are being treated with vasoactive or phlebosclerotic agents which may not be suitably cared for with a peripheral IV alone. Some central lines are also placed for temporary or permanent hemodialysis access; these dialysis catheters are significantly larger than traditional double, triple, or quadruple lumen catheters placed in the emergency department or intensive care unit setting.

Central lines are placed today via the Seldinger technique, in which the chosen vein is cannulated with a needle, a guidewire is inserted to maintain a tract through the skin into the vein, and the catheter is then inserted over the wire into the vein before the wire is removed. When this procedure was performed blindly it was called the standard technique, while if it was done with ultrasound guidance it is called ultrasound guided technique.

Patients were selected from emergency hospital at zagazig university hospitals who needed CVC insertion as an important part of management plan

All Cases underwent: