How is a patient prepped for central venous access via the subclavian vein?

Updated: Aug 07, 2018
  • Author: E Jedd Roe, lll, MD, MBA, FACEP, FAAEM, MSF, CPE; Chief Editor: Vincent Lopez Rowe, MD  more...
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Local anesthesia using 1% lidocaine is required. For more information, see Local Anesthetic Agents, Infiltrative Administration.

Place the patient in the supine position. If possible, the bed should be raised to a height that is comfortable for the operator, so that bending over will be unnecessary. Do not place towels between the shoulder blades or turn the head; these have been shown to decrease the size of the subclavian vein. [5]

Place the patient in 15º of Trendelenburg position to reduce the risk of air embolism. Increasing this angle does not alleviate vessel distention, because the subclavian vein is fixed within surrounding tissue.

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