Umbilical vein catheterization

The steps for passage of an umbilical vein catheter (UVC) are as follows:

(A) After preparing the stump with antiseptic solution, place umbilical tie firmly around the base of the umbilicus with a half knot that will control bleeding from the stump but permit passage of the UVC. Cut the residual umbilical cord about 2 cm above the skin.

(B) Locate the umbilical vein (thin-walled, typically cephalad in the 12 o'clock position, and, in newborns, bleeds after cutting). For patients undergoing resuscitation outside of the delivery room, identify and remove any blood clot from the umbilical vein using a small, curved hemostat.

(B and C) While holding the base of the umbilicus with the nondominant hand, insert the preflushed UVC into the vein approximately 3 to 5 cm in a full-term infant (2 to 4 cm in a premature infant) and check for blood return.

(D) Once blood return is confirmed, secure the catheter manually or with adhesive tape and administer medications. Because emergency UVCs can frequently become misplaced during resuscitation, check for blood return prior to each use.