Inserting central venous catheters

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7012.1090 (Published 21 October 1995) Cite this as: BMJ 1995;311:1090
  1. Duncan Young,
  2. Michael Kettlewell,
  3. Helen Hamilton
  1. Clinical reader in anaesthetics Consultant surgeon Clinical nurse specialist Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford OX3 9DU

    Case for angiographically guided placement is not proved

    EDITOR,--Andy Adam's editorial suggesting that long term central venous catheters (Hickman lines) should be placed only by interventional radiologists contains many errors that seriously weaken his argument.1 His description of “traditional” surgical placement is incorrect: the lines are placed into the internal jugular vein or, less commonly, the cephalic vein and not, as he suggests, into the subclavian vein. The risks of arterial puncture in patients with coagulopathies is overstated, simply because coagulopathies should always be corrected before insertion of a central venous catheter, and the use of imaging …

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