Venous Cut Down
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Done when no other intravenous sites are available for insertion of percutaneous cannula.
Sites
- Curved artery forceps
- Dissecting forceps
- Scissors
- Scalpel
- Needle holder
- Suture materials.
Technique
- Ankle—the long saphenous vein anterior to medial malleolus.
- Antecubital fossa—the median cubital vein
- Cleanse the skin with an antiseptic solution and apply a tourniquet proximally.
- Using strict aseptic precautions, infiltrate the area with 1% lignocaine plain and make a 2-3 cm transverse incision over the expected site of veins.
- Dissect the vein clear from surrounding tissue taking care to separate the saphenous nerve at the ankle.
- Pass a loop of 3/0 chromic catgut beneath the veins and divide it into two strands.
Complication
a. Infiltrating local anesthetic 3 cm above medial malleolus
b. Incision at right angle to vein
c. Clearing the vein
d. Sling stitches around the vein
e. Making nick in vein for large cannula
f. Inserting cannula
