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Clinical Review Quiz

Ultrasound Guidance for Central Venous Catheter Placement

Frantz J. Gibbs, MD, FACEP, and Michael C. Murphy, MD

Dr. Gibbs is director of emergency ultrasound, Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, and an assistant professor of emergency medicine, Brown Medical School, Providence, RI. Dr. Murphy is a resident physician in emergency medicine, Rhode Island Hospital, Providence, RI.


The questions below are based on the article
“Ultrasound Guidance for Central Venous Catheter Placement”.


Choose the single best answer for each question.


1. Which of the following groups has a relative indication for using ultrasound guidance for vascular access instead of the landmark-guided technique?
  1. Patients with distorted anatomy, possibly secondary to radiation therapy or prior surgical intervention at the access site
  2. Patients who are not coagulopathic due to illness or medications
  3. Patients who are unconscious
  4. Patients without hypovolemia or respiratory difficulty
  5. Patients with normal body habitus and long necks
Click here to compare your answer.


2. Most of the studies in the literature have explored and supported the utility of ultrasound guidance for which approach to central venous access?

  1. The femoral vein
  2. The supraclavicular approach to the subclavian vein
  3. The infraclavicular approach to the subclavian vein
  4. The internal jugular vein
  5. The saphenous vein
Click here to compare your answer.


3. What is the most common sonographic appearance of the lumen of a vessel?

  1. White, or hyperechoic
  2. Black, or anechoic
  3. White, or hypoechoic
  4. Black, or hyperechoic
  5. Grey, or hypoechoic
Click here to compare your answer.


4. What is a key sonographic characteristic that helps differentiate vein from artery when interrogating a prospective vessel to access?

  1. Ability to visualize compression and collapse of the vessel
  2. Arterial and venous pulsations
  3. Size of the vessel’s image
  4. Thick hyperechoic venous walls
  5. Thin anechoic arterial walls
Click here to compare your answer.


5. Which transducer type and frequency range are most useful in performing ultrasound guided catheter placment?
  1. A curvilinear transducer with a 2-5 MHz frequency
  2. A curvilinear transducer with a 10-13 MHz frequency
  3. A linear transducer with a 2-5 MHz frequency
  4. A linear transducer with a 6-10 MHz frequency
  5. A sector transducer with a 6-10 MHz frequency
Click here to compare your answer.


6. Which statement best describes the short-axis approach to vessel visualization?

  1. The length of the probe is placed parallel to the long axis of the vessel, and the vessel image should appear circular or oval
  2. The length of the probe is placed parallel to the long axis of the vessel, and the vessel should be visualized along its length
  3. The length of the probe is placed perpendicular to the long axis of the vessel, and the vessel image should appear circular or oval
  4. The length of the transducer is placed perpendicular to the long axis of the vessel, and the vessel should be visualized along its length
  5. The length of the transducer is placed oblique to the long axis of the vessel, and the vessel should be visualized along its length
Click here to compare your answer.


 

Click here to read more about Ultrasound Guidance
for Central Venous Catheter Placement

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