Tunneled catheter placement sample dictation
Procedure: Double lumen tunneled catheter placement.
Technique: Informed consent was obtained. The patient was identified and placed in the supine position.
The [right] side of the neck and chest was prepped and draped in the usual sterile fashion. 1% lidocaine with epinephrine local anesthesia was administered. Under ultrasound guidance and using a micropuncture needle, the [right] internal jugular vein was accessed and a guidewire passed. The needle was exchanged for the micropuncture introducer/sheath.
A subcutaneous tunnel was developed over the chest wall connecting to the puncture site in the neck. Under fluoroscopic observation, a  cm tip to cuff double lumen [Duraflow] catheter, after being advanced through the subcutaneous tunnel, was passed into the  internal jugular vein via a peel-away sheath. The catheter tip was placed in the right atrium. Both ports had good forward flush and return. The catheter was sutured at the skin exit site and it was flushed with heparinized saline.
The incision in the neck was closed with a Vicryl suture.
The patient tolerated the procedure well, and the procedure was without complications.
Dr. , the attending interventional radiologist, was present for the critical portions of the procedure and reviewed all images obtained.
Medications: Fentanyl  mcg IV, Versed  mg IV.
Uncomplicated placement of a [right] internal jugular vein,  cm tip to cuff, double lumen tunneled catheter.