# Umbilical Vein Catheterisation

## Overview

This module describes how to utilise the exposed umbilical stump in a neonate up to 14 days old as a site for emergency central venous access. Umbilical vein catheterization (UVC) provides a safe and effective route for intravenous delivery of medication and fluids during resuscitation.

## Indications

## Contraindications

## Patient information and consent

### How do I explain this procedure?

“I need to put a drip up on your baby. This type of drip goes into a blood vessel that is in the baby’s cord.”

### What can my patient expect?

“You will see a tube protruding from your baby’s cord. When the belly button stump dries up and falls off, there will be no sign of there having been a drip.”

### What is my patient’s role?

“Please wash your hands before and after handling your baby, but you don’t have to be afraid of handling your baby. Take care not to touch or move the tube. Tell a nurse or doctor if you see any redness around the tube.”

## Preparation

###

### Documentation

### Equipment

## Site & Positioning

The baby should be normothermic and

stable

stable

If unstable, consult with a senior first, unless in the case of a resuscitation where urgent venous access is required and intravenous access elsewhere cannot be obtained.

. Inspect the baby’s buttocks and legs for abnormalities that may indicate lower limb hypoperfusion. Position the baby supine.

## Procedure

Follow medical asepsis with sterile gloves.

To remove a UVC: you need a sterile pack and sterile gloves, but not a sterile gown. Prepare as in steps 1,2, 4 and 5 above.

## Troubleshooting

There is resistance to advancing the catheter.

Advance gently with a rotating motion. It is important to prevent the formation of false passages. In some cases, loosening the umbilical tape may help. If resistance is met after entering the abdominal wall, the catheter may be coiled in the liver and should be retracted and repositioned.

The X-ray shows that the catheter is not in far enough i.e the catheter is too short.

Never push a catheter in if it is too short. Repeat the procedure with a new sterile catheter.

The X-ray shows that the catheter is inserted too far.

Decide the length to be withdrawn and identify this using the markings on the catheter. Gradually withdraw until the desired length is reached. This does not have to be done under sterile conditions.

On removing the UVC, the stump won’t stop bleeding.

Place your finger and thumb either side of the umbilicus, about 1-1.5 cm apart. Squeeze the abdominal wall together between your finger and thumb. This applies direct pressure to the umbilical vessels.

I don’t have an umbilical vein catheter.

Use a feeding tube of the same size.

## Risks

## References