TY - CHAP M1 - Book, Section TI - Ultrasound-Guided Vascular Access A1 - Adhikari, Srikar A1 - Stolz, Lori A2 - Reichman, Eric F. PY - 2018 T2 - Reichman's Emergency Medicine Procedures, 3e AB - Central venous catheterization (CVC) is essential in the management of critically ill patients seen in the Emergency Department (ED). It allows for administration of vasoactive medications, central venous pressure monitoring, fluid resuscitation, and pacemaker placement. Complications (e.g., air embolism, arterial puncture, hematoma, hemothorax, and pneumothorax) have been reported to occur in 5% to 20% of patients.1-3 Unsuccessful CVC has been reported in up to 20% of cases.4,5CVC has traditionally been performed using surface anatomic landmarks as a guide to locate the veins. CVC is not always successful using the landmark method due to anatomic variations or obscured landmarks. Factors (e.g., congenital deformities, dehydration, intravenous drug abuse, obesity, scarring, shock, and thromboses) can complicate the procedure. Ultrasound (US)-guided vascular access is widely supported in current medical practice. The use of US guidance for CVC has been endorsed by several medical societies and supported by numerous clinical trials in the literature. US guidance has been shown to improve CVC success rates, reduce mean insertion attempts, and reduce placement failure rates.6-15 US guidance allows the Emergency Physician to more precisely locate target vessels and provide real-time visualization of needle placement. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1159798226 ER -