Central venous and arterial access in children — viva

Opening (must-hit)

"Central venous and arterial access in children is the ultrasound-guided placement of a central line whose tip sits at the cavoatrial junction, or of an arterial line for beat-to-beat pressure and blood-gas sampling, performed through a sterile Seldinger sequence. I choose the site by indication and bleeding risk — internal jugular for ultrasound visibility, femoral for the emergency or coagulopathic child, subclavian for long-term tunnelled access — and I never use the subclavian site in a bleeding child because it cannot be compressed. I run needle, guidewire, dilator, catheter under direct ultrasound, confirm the tip, and apply a full CLABSI prevention bundle with a daily review of line necessity." ^{[1] [8] [12]}