Subclavian vein puncture is a technique of puncturing and placing a tube through the subclavian vein for infusion.
The puncture needle is inserted percutaneously into the subclavian vein, and a fine catheter is introduced into the needle to infuse fluids directly into the central vein; it can infuse fluids for a long time and avoid repeated peripheral venous puncture; it reduces chemical stimulation of the vascular wall; it can measure the central venous pressure at any time; and it is suitable for shocked and critically ill patients who have difficulty in infusing fluids into the peripheral veins, as well as those who have received chemotherapy.
The puncture point is 1cm below the junction of the middle and inner 1/3 of the clavicle. When puncture is performed, the patient lies down or slightly elevates the feet to make the vein full, and the shoulder blade is slightly elevated under the shoulder blade to elevate the middle part of the clavicle and separate the subclavian vein from the tip of the lung.
After disinfection and local anesthesia, the tip of the needle is pointed to the medial end of the clavicle, and the longitudinal axis of the sternum at an angle of about 40 degrees, and the plane of the chest wall at an angle of about 15 degrees, and the back of the clavicle is slowly stabbed against the back of the clavicle for about 3 to 4 centimeters with a sense of penetration, and the side of the needle while suctioning and again with a sense of penetration with a sense of venous blood flowing into the syringe, indicating that the puncture is successful.
Avoid puncture into the artery and lung tip, resulting in arteriovenous fistula, hemorrhage, pneumothorax, etc.; on-time anticoagulation to prevent deep vein thrombosis, pulmonary embolism.
Subclavian vein puncture is technically demanding, difficult and risky, and should be performed in a qualified hospital by an experienced physician, and any accidents should be handled appropriately in time.