Central Lines Quiz

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Central Lines Quiz

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You are caring for a 64 yo female with sepsis. She is hypotensive and you would like to place a central line using ultrasound guidance. Which of the following is not an absolute contraindication to performing the procedure?

A. Infection over insertion site

B. IJ Venous thrombus seen on US

C. Abnormal anatomic anomaly

D. Patient is on coumadin

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As you place the US probe over the patient's neck in preparation for the procedure you attempt to identify the internal jugular vein. Knowing the neck can occasionally have variable anatomy, what is the typical location and appearance of the IJ?

A. Smaller and posterior to the artery.

B. Larger and anterolateral to the artery.

C. Pulsating structure medial to the artery.

D. Large structure lying over the vertebral body.

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You are having trouble identifying the IJ and are concerned that the patient's volume status is the cause. What is your next step to improve visualization of the IJ?

A. Place the patient in trendelenburg.

B. Stop procedure and give fluid bolus.

C. Ultrasound the inferior vena cava.

D. Raise the head of the bed.

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