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Femoral Access

  • Slide 1 of 2
  • Slide 2 of 2

Femoral

  • Indicator to your left, patient’s right
  • Note saphenous vein enters from medial side
  • Common femoral vein bifurcates quickly:
    femoral vein goes deep to artery
  • Access should be proximal

femoral vein

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Narration

So femoral central venous access is often performed using the landmark approach where you palpate the artery and then go medial to that to put the catheter in without ultrasound guidance. This may work a lot of the time, but as highlighted in the initial legal cases, this can go wrong and I have seen people certainly put catheters in the wrong place in the artery when they don't use ultrasound guidance correctly. Ultrasound can help you to delineate exactly where that vein is relative to the artery. Again we are seeing it here, compressing it and the veins will compress as opposed to the artery, that takes a lot more pressure to cause it to collapse. We are also seeing in this particular image the saphenous vein which is coming in from the medial side in the right upper corner of that image.

Femoral overlap

sonography text

         Continue           


Narration

One key thing to understand is that the femoral vein tends to go deep to the artery fairly quickly as it goes distally from the inguinal ligament. So a lot of times you want to be fairly proximal in order to get a good access site for the femoral vein. this is a good lesson in general just to look how quickly that vein goes deep to the artery and how high you generally have to access it to get it right.


Procedural Ultrasound

--- Table of Contents ---

Lesson NameMinutes id
Introduction5
111
Basics3
112
In and Out of Plane4
113
Peripheral Vascular Access4
114
IJ Access2
115
Femoral Access2 checkmark
116
Subclavian Access & Confirmation3
117
Other Procedures3
118
Thoracentesis & Paracentesis3
119
Cardiac Procedures4
120
US Guided Nerve Block1
121
Look Before You Stick!4
122
Quiz Question #11
123
Quiz Question #21
124
Quiz Question #31
125

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