- Used in newborns for Exchange transfusion
- As a venous access for giving IV fluids, drugs etc.
- Written consent is necessary
- Flush the catheter with heparinized saline to ensure there is no air present in the catheter and to prevent clotting.
- Parts preparation.
- Grasp the umbilical stump with non-toothed forceps and apply upward traction to straighten the umbilical stump.
- Take a scalpel and make a transverse cut completely through the umbilical stump 1 to 2 cm from the skin.
- Identify the two umbilical arteries by their thicker walls and the umbilical vein by its position at 12 o’clock and its larger thin-walled appearance.
- Gently introduce umbilical vein catheter with the iris forceps.
- If the line placement is for emergency access, advance the catheter 1 to 2 cm past the point of initial blood return in the catheter, which is usually 4 to 5 cm in a full term.
- If the line placement is for more long-term access, the line should be advanced into the inferior vena cava just beneath the right atrium, which is usually 10 to 12 cm in a full-term neonate.
- Position line must be confirmed with X-ray imaging to be above the diaphragm but below the right atrium before use to avoid complications.
- Secure the catheter using a suture through the cord.
The placement of umbilical vein catheters should is not an option in patients with gastroschisis, omphalitis, omphalocele, peritonitis, necrotizing enterocolitis.
Infection, thrombosis, thromboembolism, umbilical artery rupture
