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Journal

Journal

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Published by rachael

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Published by: rachael on Jan 16, 2009
Copyright:Attribution Non-commercial

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04/09/2014

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 JOURNAL JOURNAL
VENOUS CUT DOWN: A QUICKER AND SAFER TECHNIQUE
 
Introduction
Venous cut down is an emergency procedure that is potentially life saving. It istaught in the ATLS (Advanced Trauma Life Support) course, and might often need tobe performed by the inexperienced in severely ill trauma patients. It is one of the fewmodern surgical procedures in which speed is a crucial factor due to the presence of hypovolemic shock. An important drawback is the difficulty in cannulation of thevein. We describe simple modifications in the conventional technique that make theprocedure safer and faster.
 
 Technique
Step I
 The great saphenous vein at the ankle is commonly used for the procedure; although other sitesare also available. After isolation of the vein in the usual manner1, a loop of thread is passed underthe vein as shown in the figure 1. The apex of the loop is then divided.
 
Step 2
 The distal ligature is knotted and the ends of the proximal ligature are held without knotting.A needle (21G needle or the needle of the intravenous cannula which is to be used for thecannulation) is used to transfix the vein at the proposed site of cannulation, as shown in
figure 2
.

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