Placement of Catheters for Hemodialysis/Pheresis (HD) Utilizing Ultrasound (US) and Fluoroscopy
This chapter describes the surgical procedure for placement of catheters for hemodialysis/pheresis (HD) utilizing ultrasound (US) and fluoroscopy, as performed by the following approaches: fluoroscopic/ultrasonographic guidance. The text includes an introduction that outlines the indications, risks, benefits and alternatives, essential steps, needed equipment, and variations in operative techniques. This is followed by a template operative dictation, which provides the reader with an operative report, such as is found in a patient chart or electronic medical record. A description is provided of the following critical concepts for this procedure: confirm anatomy/indications, review protocols, gather supplies, utilize ultrasound guidance to localize internal jugular vein, prep and drape, access vessel, Seldinger technique to place HD catheter, secure catheter in place following tunneling, and imaging chest radiograph (CXR)/fluoroscopy to evaluate placement and check for pneumothorax.