Five-Lumen Catheter in the Left Internal Jugular Vein [CASE 03]

This case-based procedural review presents the placement of a pentalumen central venous catheter in the left internal jugular vein in an intensive care setting. The lesson focuses on procedural reasoning and technique, including antisepsis with chlorhexidine and alcohol-based solution, wide sterile field preparation, ultrasound probe protection, local anesthesia, ultrasound identification of vascular structures, needle entry, guidewire passage, skin nick creation, dilation, catheter advancement, lumen testing, fixation, and final dressing.

The case highlights practical considerations relevant to critically ill patients, including limited neck access, the need for multiple infusion routes, and the importance of maintaining sterility throughout the procedure. The content is intended for educational review and should be interpreted in the context of local protocols, institutional standards, supervision requirements, and current clinical guidelines.

INCLUDED CONTENT

• Case-based procedural narration
• Ultrasound-guided internal jugular venous access review
• Sterile field preparation and ultrasound probe covering
• Local anesthetic infiltration step
• Needle puncture and guidewire passage sequence
• Skin nick and dilation discussion
• Pentalumen catheter advancement over guidewire
• Lumen flushing and flow/reflux check concepts
• Catheter fixation with sutures
• Final dressing considerations

TARGET AUDIENCE

• Intensive care physicians
• Cardiology and intensive cardiology trainees
• Critical care fellows and residents
• Anesthesiology trainees involved in vascular access
• Emergency medicine clinicians learning central venous access
• ICU nurses and advanced practice clinicians seeking procedural familiarity
• Medical educators teaching central venous catheterization

EDUCATIONAL NOTICE

This material is intended for medical education and procedural review only. It does not replace supervised training, institutional protocols, current clinical guidelines, manufacturer instructions, or qualified clinical judgment. Central venous catheterization should be performed only by appropriately trained professionals with proper supervision, equipment, monitoring, and safety precautions. Human expert review is mandatory before educational or clinical use.