About Video

The preferred site of cannulation is the internal jugular vein (IJV) although subclavian or femoral vein can be used. The sterile sheath that covers the PAC must be secured at both ends to prevent contamination of the outer portion of the catheter. All the lumens are flushed with heparinized saline and the distal port hub is attached to the transducer. The IJV is punctured with an 18 G needle, a flexible guidewire is passed and the needle removed. The nick on the neck has to be larger to accommodate a large bore introducer sheath which has a hemostasis valve at its outer end and a sidearm extension for intravenous (IV) access. A stopcock can be attached to the extension to prevent spillage of blood during cannulation. An 8 Fr sheath with vein dilator is passed over the guide wire. The sheath remains in the IJV after the dilator and guidewire are removed. Patency and symmetry of the balloon is tested by inflating it with 1.5 mL of air from a volume limited syringe.