Inserting Central Lines

Question 1

What is the function of the thoracic duct?

Answer 1

It is the main lymphatic channel for the return of chyle to the venous system. It drains lymph from both lower limbs abdomen left hemithorax, left upper limb and left face and neck.

(from Radiopaedia)

Question 2

If a second attempt at inserting the finder needle is required, hold pressure with gauze for…

Answer 2

… 3-5 minutes before trying again in order to prevent hematoma formation.

(from Crit IQ, YouTube)

Question 3

What are the 4 considerations which favor a right IJ approach over a left IJ approach?

Answer 3

The left IJ is a less direct route to SVC, it’s smaller in caliber,
the left pleural dome is higher, increasing the risk of pneumothorax,
and the left IJ is in close proximity to the thoracic duct

(from Crit IQ, YouTube,
https://youtu.be/fZyxzzn11QM)

Question 4

What is the desired depth of insertion for a right IJ?

Left IJ?

Answer 4

12 - 15 cm for right

14 - 18 cm for left