TUNNELED DIALYSIS CATHETER PLACEMENT

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Pre-op:

  • Check potassium
  • Check coags: If INR elevated, may need to place a temporary catheter or use thrombin in the tract. 

Equipment Always Necessary

  • Palindrome Cather *
  • Micropuncture
  • Wire: Amplatz 75cm
  • Pen
  • 2-0 nylon suture
  • 4-0 caprosyn suture
  • Dermabond
  • Green caps (2)
  • Heparin 1000u/ml (~6cc)
  • Biopatch

PREP:

  • POSITION: Supine
  • DRAPE: Thyroid drape
  • US and probe cover
  • Draw a ruler on the table
  • Need scout image
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Stand by Equipment

  • 5Fr 40cm KMP catheter
  • Contrast - if difficult access may need venogram
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Dressing:

  • Biopatch
  • Tegaderm
  • Don't forget hep lock

PEARLS:

  • In general, the preference is the RIJ.  Will use the left if RIJ infected/occluded.
  • Will avoid pacemaker side.