Introducer sheath placement

  1. Cleans area with chlorhexidine swab
  2. Place small drape
  3. Clamp sideport of CVL
  4. Locate femoral artery pulse (midway between ASIS and pubic symphysis)
  5. Manipulate syringe and needle to aspirate blood from femoral vein located medial to artery
  6. Stabilize needle hub (left hand in wide-base like pool cue)
  7. Remove syringe with minimal movement of needle (twisting motion)
  8. Advance guidewire
  9. Remove needle
  10. Make cut at skin
  11. Place large-bore CVL with dilator (tension on skin with left hand)
  12. Remove dilator and guidewire simultaneously
  13. Aspirate air from line and flushes
  14. Secure and dress line