Category Archives: procedures

Subclavian CVC – ‘safe method’

This method allegedly reduces the risk of puncturing apex of pleura and causing pneumothorax.

Steps:

(Usual pre-procedure steps and positioning)

– Place finger (A) in supra-clavicular notch at junction of medial 1/3 and lateral 2/3 of clavicle

– Entry point 1.5-2.0cm below junction of medial 2/3 and ┬álateral 1/3 of clavicle

– Angle needle towards finger (A) just under clavicle, walking off if necessary. Often hit subclavian vein in this trajectory.

– If no puncture then systematically re-orientate needle towards supra-sternal notch in stepwise fashion.

This method should avoid breaching the pleura

– JB, GGH