Central venous catheterization

Central venous access remains a cornerstone of resuscitation and critical care in both the emergencydepartment (ED) and intensive care unit. Advanced hemodynamic monitoring, rapid infusion of fluid, placement of transvenous pacemakers, and administration of selected medications all require reliable central venous access. Central venous catheterization has also gained acceptance in the resuscitation and treatment of critically ill patient. Over the past decade, the increased availability of, training in, and provider competence in bedside ultrasonography have had a significant impact on the standard approach to both peripheral and central venous catheterization. Ultrasound-guided central venous catheterization has improved success rates, reduced complication rates, decreased the time required to perform the procedure, and resulted in overall cost savings.