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cutdown image from New Medical Terms

schematic of CD technique


Definition An incision through skin and subcutaneous tissue into a major blood vessel, usually a vein–hence, venous cutdown (CD), to facilitate rapid and direct vascular access, followed by insertion of a cannula under direct visualisation.

CDs are waning in popularity; intraosseous infusion is an increasingly preferred strategy for rapid fluid management of trauma and shock.

Veins used 

• Basilic vein–above elbow

• Cephalic vein–at shoulder

• External jugular vein–at neck

• Saphenous vein (most commonly used)–at ankle

CDs are required when a percutaneous placement of a venous cannula is not possible, there is no good vein, in emergent situations, or in the face of global venous sclerosis–as occurs with long-term IV drug use; any peripheral vein can be used. 

Complications Cellulitis, haematoma, phlebitis, perforation of posterior wall of vein, venous thrombosis, nerve transection, arterial transection

Synonym Venous cut down


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