In a sick neonate where peripheral venous access is not possible, placement of an umbilical venous catheter (UVC) may be lifesaving!
The umbilical vein may remain patent for up to 10 days after birth.
- Emergency resuscitation and stabilization of neonates (to give volume or medications, such as epinephrine
- Abdomen doesn’t look normal (omphalocele, gastroschisis, omphalitis, peritonitis, necrotizing enterocolitis)
- Vascular compromise of the lower limbs
Umbilical Vessel Anatomy:
From Robert and Hedge’s Clinical Procedures in Emergency Medicine
- Umbilical cord has 2 arteries and 1 vein
- Vein is thin-walled, usually at 12 o’clock
- Arteries are smaller and thick-walled
- Neonatal blood flow:
- Umbilical vein –> ductus venosus –> IVC –> RA –> PA –> ductus arteriosus –> aortic arch
- Umbilical arteries –> internal iliac arteries
Finding your Materials:
- In Hasbro ED: