The IJ begins at the jugular foramen and travels lateral to the internal and common carotid arteries, terminating at the innominate vein. It runs within the carotid sheath alongside the common carotid artery and the vagus nerve. The internal jugular vein is a paired vessel that collects blood from the head, face, and neck and delivers it to the superior vena cava (SVC). This type of central venous access can be used for nutrition, transfusion of fluids, infusion of medications, as well as hemodialysis. Placement of either tunneled catheter allows patients to continue intravenous therapy upon their discharge from the hospital.Ĭentral venous access is obtained via the internal jugular (IJ), subclavian (SC), and femoral veins. An additional benefit of this catheter is that it does not require recurrent needle-sticks for access. It has a cuff surrounding the catheter, which secures it within the subcutaneous tissues and comes in a variety of diameters and access ports. In contrast, the tunneled CVC without a subcutaneous port exits the skin at a distance from the venous puncture site. It is accessed via needle-stick to allow infusion of medication, intravenous fluids, and/or nutrition. This port is placed on the chest wall, under the skin and subcutaneous tissues. The subcutaneous port typically has one or two lumens and ends in either a single or double port, respectively. There are two major types of tunneled CVCs: those ending in a subcutaneous port and those that exit the skin as access catheters. As such, tunneled CVCs can be in place for weeks to months, while the non-tunneled catheters must be exchanged every few days to a week. Unlike non-tunneled central venous catheters (CVCs), tunneled CVCs travel under the skin and terminate away from the venous access site.
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