Femoral Central Line
More recent data suggests there is no increased risk in catheter-related infections with femoral access, compared with other sites - Anthony DeVivo DO
HWN Suggests
Getting Flash! The Blind “Fem” Line
Like any procedure, positioning is critical! Placing the patient in reverse Trendelenburg can increase the cross-sectional area and exposed width of the femoral vein, and it may help mitigate any respiratory distress your patient may be in. If a large pannus is obstructing the insertion site, be sure to have someone manually retract it or use tape to anchor it to the bed rail. Lastly, flexion and external rotation of the ipsilateral hip or the “frog-leg position” is critical
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Ultrasound guided cannulation of the femoral vein
Ultrasound is now recommended as the standard approach in central venous cannulation of the femoral vein (Franco-Sadud et al. 2019). Research shows that ultrasound-guidance reduces number of cannulation attempts, improves success rate and reduces mechanical complications, even by inexperienced operators (Airapetian et al. 2013; Seto et al. 2010).
Articles of Interest
Femoral Vein Central Venous Access
When obtaining the central venous access in the femoral vein, the key anatomical landmarks to identify in the inguinal-femoral region are the inguinal ligament and the femoral artery pulsation. In most instances, central venous access with ultrasound-guidance is considered the standard of care. Nevertheless, the understanding and use of anatomical landmarks are equally important and when used in combination with ultrasound guidance, lead to increased success.
Femoral Vein for Central Line Placement
In this video Dr. Johnson demonstrates his technique for visualizing the femoral vein with ultrasound, and describes how he performs an ultrasound-guided central line insertion.
Pearls, pitfalls, tips and tricks for procedures: Part 1
If the artery cannot be felt, place a thumb on the pubic symphisis and index finger on ASIS, and use the apex of the V-shape of your 1st web space to find the femoral artery, then move 1cm medial at level of inguinal ligament. The optimal position is usually with the hip in external rotation & abducted.
Ultrasound Guided Insertion of a Femoral Vein Catheter
In this educational video you will see a demonstration of the ultrasound guided Ultrasound Guided Insertion of a Femoral Vein Catheter.
