Ultrasonographically guided puncture technique for central venous vessels as a one-person technique

The traditional anatomic landmark technique usually allows a rapid and easy central venous access but this technique is not always successful and can be associated with severe complications. We developed an ultrasonically guided one-operator-catheterization technique whereas a second operator to place and hold the ultrasound transducer is not necessary. The catheterisation technique consists of 3 functional components: the swivel arm, the ultrasound unit and the conventional Seldinger central venous catheterization technique. As swivel arm we used a device with a 300 mm column with a 700 mm span attached to ultrasound unit. There were 234 catheterizations of the internal jugular vein performed in the period of January 1999 to July 1999. The indication and complication rate for the catheterization procedure was documented. There were 2 plexus irritations and 1 hematoma observed in all performed catheterization procedures which remained without therapeutic consequences. Once the decision for central venous access has been made the safest technique should be applied. The ultrasonically guided catheterization technique allows a fast, safe and convenient central venous access for our patients.