For the newborn who requires emergency IV access, emergency umbilical vein catheterization is the most rapid and effective method.
All the text that follows is from the narration of the YouTube Video.
The 3 x 3 Method for Placing Emergency Umbilical Venous Catheters (UVCs) is by Drs. Bryne and Strand from the Indiana University School of Medicine Department of Pediatrics and is available on YouTube titled Emergency UVC Placement.
3 steps with three things to remember in each step:
- 3 supplies necessary to place a UVC
- 3 steps to prepare the infant for emergency UVC placement
- 3 steps to prepare the catheter for emergency UVC placement
The indications for emergency umbilical vein catheterization are well described in the Neonatal Resuscitation Textbook, 6th ed, 2011 which is available for purchase at the American Academy of Pediatrics website.
3 things needed to insert an emergency UVC catheter:
1. UVC tray
2. A single lumen 3.5 F or 5.0 F umbilical catheter
3. A syringe filled with saline flush
3 things to Prepare the Baby: 1. Clean the umbilical cord with Providine or other antibiotic solution. 2. Tie the cord with umbilical tape 3. Cut the umbilical cord with a scalpel below the umbilical clamp to about one to two cm from the skin.
The speaker states “Note that there is no time for sterile gown or sterile gloves or need for drapes in the placement of an emergency UVC unlike the more controlled and sterile placement of non-emergent umbilical catheter.”
3 things you need to do to prepare the catheter:
1. Attach a three way stopcock to the catheter
2. Attach syringe with saline flush to stopcock
3. Flush the catheter
You are now ready to insert the catheter into the umbilical vein which is easily identified as the larger more thin walled opening in the umbilical cord.
Insert the UV catheter to about 3 to 4 cm until you get free flow of blood when you open the stopcock and and gently aspirate. Now you are ready to administer resuscitation medicine or volume expanders.
You will need to be familiar with the three-way stopcock found in your umbilical tray to work efficiently.
Watch the video as it is only five minutes long and well worth your time.