Skip to Main Content


  • • Any situation that requires central venous access or venous access that cannot be obtained peripherally.

    • An emergency resuscitation requiring administration of large amounts of fluids.

    • The need for central venous pressure monitoring.

    • Placement of a pulmonary artery catheter.

    • The need for frequent blood draws.

    • Infusion of hyperalimentation, concentrated solutions (ie, KCl, dextrose concentrations greater than 12.5%, chemotherapeutic agents, hyperosmolar saline).

    • Infusion of vasoactive substances (ie, dopamine and norepinephrine) that can extravasate and cause soft-tissue necrosis.

    • The need for hemodialysis.


Advantages of Catheter Placement at Femoral Site


  • • It does not interfere with procedures or monitoring involving the head, neck, or chest (such as cardiopulmonary resuscitation).

    • Pressure can be applied easily in the event of femoral artery puncture or catheterization.

    • It leaves the patient’s neck free of devices.


Disadvantages of Catheter Placement at Femoral Site


  • • It is a relatively “dirty” area (though this can be managed with good sterile technique and dressing changes).

    • Placement of a long line is required for central venous pressure monitoring.

    • It can be challenging to place a pulmonary artery catheter through a femoral venous catheter.




  • • Severe abdominal trauma (provided that adequate venous access can be obtained elsewhere).




  • • A patient with distorted anatomy or landmarks.

    • Risk factors for excessive bleeding, such as thrombocytopenia, coagulopathy, and anticoagulant or thrombolytic therapy.

    • Skin lesions (such as cellulitis, burns, abrasions, or dermatitis).

    • Conditions that predispose the patient to sclerosis or thrombosis (such as vasculitis).

    • Known thrombus of the femoral vein.


  • • The catheter.

    • An appropriate size guidewire (at least 2 times the length of the catheter).

    • An appropriate size introducer needle.

    • A tissue dilator if the catheter is larger than 3F.

    • Two or three 3- to 5-mL syringes.

    • 1% lidocaine and a 26-gauge needle to inject the lidocaine.

    • Skin preparation solution (either 2% chlorhexidine-based preparation for patients older than 2 months or 10% povidone-iodine).

    • Sterile drapes.

    • Scalpel blade.

    • Suture (ie, 3.0 silk).

    • Sterile gauze pads.


  • • Bleeding (can usually be managed by applying pressure to the site).

    • Infection (can be minimized with the use of good sterile technique during placement and regular catheter care).

    • Embolization of the guidewire if the operator does not use proper technique.

    • Vessel perforation.

    • Embolization of a preexisting thrombus.


  • • Attach the insertion needle so that the numbers on the syringe are facing up when the bevel is in the upward position. This way, you will always know how to hold the syringe so that the bevel is facing upward.

    • After the skin is punctured with the insertion needle, inject a small amount of saline (approximately 0.2 mL) into the subcutaneous tissue.

    • • This will clear the ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPediatrics Full Site: One-Year Subscription

Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPediatrics

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.