Umbilical vessel catheterization

Essential equipment

Umbilical catheter (a 5 French feeding tube is usually most accessible)3-way stopcock or needle-free capScalpelAntisepticUmbilical tape or silk sutureSaline flush

Steps

  1. Place the newborn beneath a radiant warmer if possible.

  2. An assistant can help position the infant.

  3. Prepare your equipment: flush the catheter and cap it with a needle-free cap or 3-way stopcock in the “off-to-patient” position.

  4. Appropriately prepare and drape the area. Hold the umbilical stump upright and scrub the cord with antiseptic solution.

  5. Place a loop of umbilical tape or a purse-string suture at the junction of the skin and the cord.

  6. Cut the cord with a scalpel 1-2 cm from the skin. Identify the vessels (1 vein, 2 arteries).

  7. Gently advance a pre-flushed catheter into the vein.

  8. Advance only 1-2 cm beyond point at which good blood return is obtained (usually 4-5 cm for term-sized infant). Tighten the umbilical tape or purse-string suture to hold catheter in place.

  9. Secure and dress line.