A single venipuncture technique for placement of multiple central venous catheters

Surgeons are frequently called upon to place central venous catheters for various purposes. With the increasing used of central vein hyperalimentation, these catheters have become quite widely used. Often, critically ill patients require simultaneous infusions of vasopressors, fluids, blood and/or blood products, and hyperalimentation. In patients who have had peripheral intravenous catheters indwelling for long periods, often no peripheral access routes are available. Central venipuncture carries a definite risk of pneumothorax, hemothorax, and arterial puncture. The technique presented here allows the placement of multiple centra venous catheters via a single venipuncture. Each catheter is a completely separate venous conduit and may be used to infuse any number of substances alone or concurrently with others. Materials needed for this technique are: One 18-gauge Thinwall needle Two 20-cc Luer tip syringes Two 16-gauge 8" or 12" intravenous catheters* Two separate bags of infusion fluids and tubings One bottle 1% xylocaine Two .035" floppy end spring guidewires, 40 cm long One 8 French percutaneous dilator-introducer kit One 11 knife blade One mosquito curved hemostat Sterile towels, gauze sponges, sutures of choice, antiseptic *(This equipment is required for the placement of only two catheters).