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  • Need for acute resuscitation.
    • Trauma.
    • Critical care monitoring.
  • Need for long-term central venous access.
    • Total parenteral nutrition.
    • Chemotherapy.
    • Hemodialysis.
    • Long-term antibiotic therapy.
    • Limited peripheral access in ill child.

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Absolute

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  • None.

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Relative

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  • Coagulopathy.
  • Severe thrombocytopenia.

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  • The patient is most often positioned supine with a shoulder roll in place.
  • If a saphenous vein cutdown or femoral vein catheterization is planned, the leg should be straight and abducted away from the midline.

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  • All lines except radial arterial lines require a post-procedure radiograph to confirm catheter position and look for complications.
    • These films may pick up a subtle pneumothorax not seen by fluoroscopy during catheter placement.
  • Meticulous aseptic technique must be used for routine catheter care and every time the catheter is accessed for infusion or blood draw.

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Acute

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  • Pneumothorax.
  • Hemothorax.
  • Catheter malposition.
  • Pericardial tamponade.

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Chronic

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  • Catheter infection.
  • Bacteremia and line sepsis.
  • Catheter thrombosis.
  • Vessel thrombosis.
  • Septic emboli.
  • SVC syndrome.

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