Case 6-2 LOCATION: Inpatient, Hospital PATIENT: Tim Luther ATTENDING/ADMIT PHYSICIAN: Frank Gaul, MD SURGEON: David Barton,...

Case 6-2

LOCATION: Inpatient, Hospital

PATIENT: Tim Luther

ATTENDING/ADMIT PHYSICIAN: Frank Gaul, MD

SURGEON: David Barton, MD

PREOPERATIVE DIAGNOSIS: Fluid overload state, no urine output, acute renal failure.

POSTOPERATIVE DIAGNOSIS: Fluid overload state, no urine output, acute renal failure.

PROCEDURE PERFORMED: Temporary dialysis catheter placement.

PROCEDURE: This 77-year-old patient was brought to the emergency room. The right femoral vein was selected. This was tried with the left IJ vein earlier without success. I reserved the right IJ for a central line that will be placed by interventional radiology in the morning. The right femoral vein was localized using ultrasound. (The ultrasound is not a reportable service.) The area was prepped in the usual fashion. One-percent lidocaine was used for local anesthesia. The right femoral vein was accessed under real-time ultrasound guidance without difficulty. The guidewire was advanced smoothly. The hook needle was taken out. The right femoral vein was dilated. An 11.5 French 16-cm temporary dialysis catheter with a straight extension was advanced to the iliac vein through the right femoral vein over the guidewire using the Seldinger technique without difficulty. Both ports had good venous blood return. Both ports were flushed with saline and heparin. The catheter was secured to the skin. The patient tolerated the procedure very well without immediate complication. Dialysis will be done semi-urgently.

CPT Code(s): _________________

ICD-10-CM Code(s): ________________

Abstracting Questions:

1. What is another name for a catheter or central line?

2. What vessel was used for the access point for the catheter?

3. Was the insertion central or peripheral?

Solutions

Expert Solution

1. It also named as PICC line insertion which is a line use for long term course.

2. The major veins such as brachial femoral are usually chosen for the insertion here it was femoral

3. Even it using a vein it considered as a Central vein catheterization

Nightingale answered 2 years ago

Next > < Previous

Related Solutions

LOCATION: Inpatient, Hospital PATIENT: Simon Sulten ATTENDING PHYSICIAN: Gary Sanchez, MD SURGEON: Gary Sanchez, MD PREOPERATIVE...

LOCATION: Inpatient, Hospital PATIENT: Simon Sulten ATTENDING PHYSICIAN: Gary Sanchez, MD SURGEON: Gary Sanchez, MD PREOPERATIVE DIAGNOSES 1. Colostomy for obstructing colon cancer. 2. Cholelithiasis. POSTOPERATIVE DIAGNOSES: Same as Preoperative. PROCEDURES PERFORMED 1. Takedown colostomy with end-to-end colorectostomy. 2. Open cholecystectomy. ANESTHESIA: General. PROCEDURE: The patient was brought to the operating room, placed under general anesthesia, and prepped and draped sterilely. The previous midline was reopened with the #10 blade, and we excised the old scar. We carried our dissection...

LOCATION: Inpatient, Hospital PATIENT: Melissa Houtena ATTENDING PHYSICIAN: Andy Martinez, MD SURGEON: Andy Martinez, MD PREOPERATIVE...

LOCATION: Inpatient, Hospital PATIENT: Melissa Houtena ATTENDING PHYSICIAN: Andy Martinez, MD SURGEON: Andy Martinez, MD PREOPERATIVE DIAGNOSES 1. Three prior cesarean section deliveries. 2. Voluntary sterilization. POSTOPERATIVE DIAGNOSIS: Same as Preoperative. PROCEDURES PERFORMED 1. Repeat lower segment transverse cesarean section. 2. Bilateral Pomeroy tubal ligation. ANESTHESIA: General. PREAMBLE: The patient is a 30-year-old woman, gravida 4, para 3, at 36 weeks and 2 days gestation who presented initially to her hometown obstetrician in spontaneous labor. Because of her previous cesarean...

Case 1-1 LOCATION: Inpatient, Hospital PATIENT: Mike Bahs ATTENDING PHYSICIAN: Loren White, MD CONSULTANT: Timothy Pleasant,...

Case 1-1 LOCATION: Inpatient, Hospital PATIENT: Mike Bahs ATTENDING PHYSICIAN: Loren White, MD CONSULTANT: Timothy Pleasant, MD REASON FOR CONSULTATION: Rule out neck injury. HISTORY: This patient is a 17-year-old male who was involved in a motor vehicle accident last night. He remembers driving down the road and the next thing he remembers was trying to reach for his cell phone at a stop sign after the accident. He does not remember any of the details. The car apparently went...

LOCATION: Outpatient, Hospital PATIENT: Beth Mahoney PRIMARY CARE PHYSICIAN: Ronald Green, MD SURGEON: Mohomad Almaz, MD...

LOCATION: Outpatient, Hospital PATIENT: Beth Mahoney PRIMARY CARE PHYSICIAN: Ronald Green, MD SURGEON: Mohomad Almaz, MD PREOPERATIVE DIAGNOSES 1. Chondromalacia, left knee. 2. Torn left medial meniscus per MRI scan. POSTOPERATIVE DIAGNOSIS: Chondromalacia, left knee. PROCEDURES PERFORMED 1. Examination, left knee, under anesthesia. 2. Arthroscopy, left knee, with debridement of chondromalacia. ANESTHESIA: General with endotracheal intubation. FINDINGS: The patient was found to have significant chondromalacia in all three compartments. She had some bare bone on the femoral trochlear and significant...

LOCATION: Inpatient, Hospital PATIENT: Jo Littledove REFERRING PHYSICIAN: James Noonar, MD CARDIOLOGIST: Marvin Elhart, MD INDICATIONS:...

LOCATION: Inpatient, Hospital PATIENT: Jo Littledove REFERRING PHYSICIAN: James Noonar, MD CARDIOLOGIST: Marvin Elhart, MD INDICATIONS: Abnormal Cardiolite stress test and shortness of breath. PROCEDURE: Right and left selective coronary angiogram, LV gram left heart, right femoral artery #6 French sheath, right femoral artery angiogram. HEMODYNAMICS: Aortic pressure 138/57, LV 148/4. No aortic gradient on pullback. RESULTS: Ventriculography: The LV displayed normal size with excellent contractility and no segmental wall motion abnormality. The ejection fraction is estimated at 60-80%. Coronary...

Assign CPT and ICD-10-CM codes to this Radiology Service. LOCATION: Inpatient, Hospital PATIENT: Jessie Gunderson PHYSICIAN:...

Assign CPT and ICD-10-CM codes to this Radiology Service. LOCATION: Inpatient, Hospital PATIENT: Jessie Gunderson PHYSICIAN: Robert Brown, M.D. RADIOLOGIST: Morton Monson, M.D. EXAMINATION OF: X-Ray Chest CLINICAL SYMPTOMS: Acute Respiratory failure PORTABLE CHEST, 5:00 a.m.: Comparison is made with the previous study. The cardiac silhouette is again enlarged. Since the previous study, endotracheal tube and nasogastric tube have been apparently removed. Central venous catheter is unchanged in position. There again appears to be evidence of an aortic balloon pump...

1.1 LOCATION: Inpatient, Hospital PATIENT: Elaine Snow PHYSICIAN: Andy Martinez, M.D. ADMITTING DIAGNOSIS: Endometrial hyperplasia and...

1.1 LOCATION: Inpatient, Hospital PATIENT: Elaine Snow PHYSICIAN: Andy Martinez, M.D. ADMITTING DIAGNOSIS: Endometrial hyperplasia and postmenopausal bleeding. DISCHARGE DIAGNOSES: 1. Adenomatous endometrial hyperplasia. 2. Intramural and subserosal leiomyomata. 3. Hypertension. PROCEDURE PERFORMED: Total abdominal hysterectomy with bilateral salpingo-oophorectomy carried out. COMPLICATIONS: Bleeding from small bowel mesentery, oversewn by Dr White at the time of procedure. HISTORY OF PRESENT ILLNESS: The patient is a 57-year-old woman who had been seen with complaints of postmenopausal bleeding. Dilation and curettage had been...

Subjects