Ultrasound-guided intravenous catheter insertion in a prone patient using a T probe in emergency setting

Central venous catheterizations are common intraoperative procedures.Central venous catheter (CVC) placements are usually performed with patients lying in the supine position using real-time ultrasound (US) guidance.

A 43-year-old man underwent open right popliteal artery reconstruction in the prone position for a limb-threatening injury. Excessive continuous intraoperative bleeding, increased by a coexisting pelvic fracture, was temporarily stabilized by a T POD device, but with the need of external fixation, required the placement of CVC, which was not feasible whilst in the prone position without US help.A view of the left internal jugular vein (IJV) was obtained with pediatric T probe and a CVC was placed using real-time US guidance, without complications.

We demonstrated the feasibility and safety of US-guided CVC placements in an emergency setting.