How to place and maintain a jugular catheter
Abstract
The purpose of the article is to provide a step by step guide to placement of a jugular catheter and maintenance.
Advantages of placing a jugular catheter include increased comfort for patient, ease of use for nursing staff, multi lumen allowing blood sampling, intravenous fluid access and parenteral nutrition to be given if required to the same patient. Disadvantages include increased risk of infection and introduction of foreign material into the central circulation, with far more serious consequences than peripheral vessel contamination therefore the increased need for proper aseptic technique for both placement and management.
The purpose of this article is to give detailed instruction on how to place a jugular catheter. It will discuss appropriate occasions for placement and care and maintenance of the catheter.
Indications for placement of a catheter into a jugular vein include:
The introduction of foreign material or infectious agents into the central circulation can have far more serious consequences than peripheral vessel contamination; maintenance of aseptic technique is vital when placing jugular catheters.
It is worth noting that there are other sites for central venous access, e.g. the femoral vein but for the purpose of this article only the jugular vein will be discussed.
There are a number of contraindications to using a jugular catheter. These include:
The compound used to make different types of catheters affects rigidity, reactivity and thrombogenicity. For example, catheters made of silicone and polyurethane are less thrombogenic than other materials such as polypropylene.
The length and gauge of catheter required is dependent on the purpose of the catheter and the patient size. Critically ill patients often require large volumes of fluid and therefore the largest gauge catheter should be placed. Length is important if the patient needs central venous pressure monitoring
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