A Central Venous catheter is inserted in which veins, EXCEPT?

Appeared in: AIIMS Delhi NO - 2018

Explanation

The saphenous vein is a large superficial vein located in the leg, running from the foot up to the groin.
It is a part of the peripheral venous system, which returns blood from the limbs to the central circulation.
Central venous catheters require placement in a large, central vein (like the subclavian, jugular, or femoral) so the tip terminates in the superior or inferior vena cava, close to the heart.
Because the saphenous vein is a peripheral vessel, it is not an appropriate site for placing a central line.

Option A: This is a valid site for CVC insertion. The subclavian vein is a large central vein located beneath the clavicle.
Option B: This is a valid site for CVC insertion. The internal jugular vein in the neck is a large, direct pathway to the superior vena cava.
Option C: This is a valid site for CVC insertion. The femoral vein is a large vein located in the groin.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Central Venous Catheter (CVC) Insertion Sites as background academic context rather than a clinical decision trigger.
Site selection for CVCs is critical. The choice depends on the clinical situation, duration of therapy, and patient-specific factors. The right internal jugular is often preferred, followed by the subclavian, with the femoral vein typically being the last resort due to a higher risk of infection.
A key nursing responsibility is monitoring for complications. After a subclavian or jugular line insertion, a chest X-ray is mandatory to confirm the catheter tip is correctly placed in the superior vena cava and to rule out iatrogenic pneumothorax.
While not used for central lines, the great saphenous vein is the most commonly harvested conduit for coronary artery bypass graft (CABG) surgery.

How to Approach the Question

First, identify the keyword 'EXCEPT' in the question. This indicates that you must find the option that does not fit the criteria.
Next, recall the core concept: Central Venous Catheters are placed in large, central veins that lead directly to the heart's major vessels (vena cava).
Evaluate each option's anatomical location. The subclavian (chest), jugular (neck), and femoral (groin) veins are all major central vessels.
Consider the location of the saphenous vein. It is a primary superficial vein of the leg.
Conclude that since the saphenous vein is a peripheral vein, not a central one, it is the exception and the correct answer.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 105-107

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