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Paeds Casesinvestigations-procedures-and-technology

Paeds Cases · investigations-procedures-and-technology

Place the right line at the right depth — umbilical venous and arterial catheterisation

A bedside structured clinical encounter testing safe umbilical catheterisation in a sick preterm infant — the vessel anatomy and courses, the Shukla birth-weight depth formula with the calculation for a 1000-gram infant, the high and low arterial positions with the high preferred and the reason, the venous target at the diaphragm, the radiographic confirmation of the tip, and the recognition and immediate management of a white limb, persistent hypertension, and line sepsis, with the dwell-time limits of five days for arterial and fourteen days for venous catheters.

structured clinical encounter (neonatal vascular access and procedural safety)4 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
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Study tools

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
A 28-week preterm infant weighing 1000 grams is admitted to the neonatal unit and needs an umbilical arterial catheter for blood-gas and blood-pressure monitoring and an umbilical venous catheter for central access and parenteral nutrition. The candidate must decide the lines, calculate the depth, confirm the position, and then recognise and manage a white limb, persistent hypertension, and a red discharging stump.

Station status

This is one MedVellum formative structured clinical encounter. The scoring, prompts and performance descriptions are educational feedback tools. They are not an official college station, timing, mark allocation, pass score or reproduced examination format. The encounter assesses the vessel anatomy and courses, the Shukla birth-weight depth formula with the calculation for a 1000-gram infant, the high and low arterial positions with the high preferred and the reason, the venous target at the diaphragm, the radiographic confirmation of the tip, and the recognition and immediate management of a white limb, persistent hypertension, and line sepsis, with the dwell-time limits. [1] [9]

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References5ShowHide
  1. [1]Shukla H; Ferrara A Rapid estimation of insertional length of umbilical catheters in newborns American journal of diseases of children (1960), 1986.PMID 3728405
  2. [6]Levit OL; Shabanova V; Bizzarro MJ Umbilical catheter-associated complications in a level IV neonatal intensive care unit Journal of perinatology, 2020.PMID 31911645
  3. [7]Barrington KJ Umbilical artery catheters in the newborn: effects of position of the catheter tip The Cochrane database of systematic reviews, 2000.PMID 10796375
  4. [9]Marshall M Radiographic assessment of umbilical venous and arterial catheter tip location Neonatal network, 2014.PMID 24985114
  5. [11]Lin YJ; Liu YC; Huang HC; et al Echocardiographic determination of umbilical catheter tip location mitigates complications: a randomised controlled trial Children (Basel, Switzerland), 2025.PMID 41300627
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