Intravascular devices and catheters can be inserted in the intensive
care unit (ICU) for a variety of purposes, including fluid and drug
administration, pressure monitoring, pacemaking, or cardiac augmentation.
Several techniques can be used to obtain access to and cannulate
the vessel. Parenthetically, these same techniques can be used for
other procedures such as thoracentesis or paracentesis.
- ▪ Needle through catheter: Large bore needle inserted
into vessel and smaller bore catheter threaded through needle into
- ▪ Catheter over needle: smaller bore needle inserted into
vessel and large bore catheter threaded over needle into vessel
- ▪ Seldinger technique: Small bore needle inserted into vessel,
wire passed through needle into vessel, needle removed, catheter
threaded over wire into vessel, wire removed
- ▪ Modified Seldinger technique: Small bore needle inserted
into vessel, wire passed through needle into vessel, needle removed,
dilator/sheath passed over wire into vessel, wire and dilator removed,
catheter threaded through sheath into vessel, sheath removed
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