title: Ultrasonic imaging as an adjunct to femoral venous catheterization in children.
abstract: Central venous catheterization is critically important to the management of burned children, but major morbidity is associated with the technical misadventures that can occur when inserting these devices. We used a bedside ultrasound device to facilitate placement of femoral venous catheters in eight edematous children with an average age of 7.0 years, weight of 23 kg, and burn size of 54%. To our knowledge, this is the first report of this technique in children. All children had central venous catheters placed in the femoral position requiring an average of 2 (range, 1 to 4) venepuncture attempts. There were no mechanical complications. We found the needle guide too cumbersome for our small patients, but found that the ability to mark the anatomy with a pen facilitated accurate catheter placement. In most patients, standard external anatomic landmarks are adequate for accurate catheter placement, however, in this initial experience, we found bedside ultrasound imaging to be a useful adjunct in selected patients with massive soft tissue edema.
authors.affiliation: Shriners Burns Institute, Boston, MA 02114, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Sheridan
authors.forename: L
authors.initials: L
authors.lastname: Petras
authors.forename: M
authors.initials: M
authors.lastname: Lydon
mesh_terms: D000293:Adolescent; D002056:Burns / Q000628:therapy*; D002405:Catheterization, Central Venous / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005268:Femoral Vein / Q000000981:diagnostic imaging*; D006801:Humans; D019095:Point-of-Care Systems; D018084:Ultrasonography, Interventional / Q000295:instrumentation