Femoral Central Venous Catheterization Theory & Practice

ANATOMY Femoral vein The femoral vein lies within the femoral sheath and courses under the inguinal ligament; it then becomes the external iliac artery. The vein is located approximately 1 cm medial to the femoral artery. The femoral nerve is lateral to the vein. Needle entry occurs 2 to 3 cm inferior to the inguinal ligament, 1 cm medial to the femoral artery pulsation. Central venous lines are essential tools in the care of complicated patients, both on inpatient wards and in the emergency department and intensive care unit. They may provide access for blood draws, facilitate central administration of fluids and medications, and allow direct measurement of cardiac filling pressure. Unfortunately, central lines are associated with serious complications, including nosocomial bloodstream infections. Recent data suggest that of the more than 200,000 such infections each year, 90% are due to central lines. One can minimize patient risk by practicing proper sterile technique during line i