Femoral Access
(continued)

Step 2: Using ultrasound, scan for selected site. Administer local anesthetic. Access of femoral vein should be below the groin region. Access vein with introducer needle. The needle should be at a 45-75 degree angle. Keep ultrasound beam focused on needle tip as it approaches vein. Image on screen should show dimpling of the vein as needle touches it, then vein rebounding as needle penetrates vein. Take care to not advance the needle past the inguinal ligament. Observe flashback of blood to confirm entry into vein.

Step 3: If using a Raulerson syringe, insert wire through the opening in the distal part of plunger. Advance the wire through the needle and into the vein approximately 15-20cm. If the wire will not thread, place your thumb on the skin below the needle and retract the skin. Then, gently thread wire. Wire can be cut on bevel of needle. Be careful not to retract the wire through the needle. Maintain visibility and control of wire at all times.

Step 4: Remove access needle by sliding it out of the skin along the wire. Slide the dilator/introducer over the wire. Perform skin nick if necessary.

Step 5: Remove dilator and stabilize the wire. Slowly thread the catheter over the wire. The wire will exit the distal lumen. Grasp the wire, maintaining control. Gently advance catheter to premeasured internal length.

Step 6: Place needleless connector on catheter lumens. Clean the insertion site to prepare for dressing and securement. Secure catheter using manufactured securement device. Apply sterile dressing in keeping with facility policy. Consider antimicrobial dressing for femoral sites.

Step 7: Follow facility policy for femoral catheter verification.


Go to Section 7:
Special Considerations