This educational case from Critical Care Cardiology reviews the step-by-step reasoning involved in placing a central venous catheter in the femoral vein under ultrasound guidance. The case highlights the femoral vein as a non-first-line central access site that may be considered when other access routes are limited or clinically unsuitable. The session focuses on the inguinal region, ultrasound identification of the femoral vein and artery, recognition of vessel overlap, compressibility assessment, needle guidance, guidewire handling, tract dilation, catheter advancement, flow and reflux checks, and final fixation with dressing placement. The content is intended for procedural education and emphasizes anatomy, sterile technique, image-guided decision-making, and safe review rather than independent procedural authorization.

INCLUDED CONTENT

• Case-based procedural narration
• Sterile preparation and field setup
• Ultrasound probe covering and gel handling
• Femoral vein and artery localization
• Discussion of vein compressibility and artery-vein overlap
• Local anesthetic preparation
• Needle-only puncture technique discussion
• Guidewire passage and ultrasound confirmation
• Dilation and catheter insertion sequence
• Triple-lumen catheter flushing and valve placement
• Flow and reflux testing
• Catheter fixation and dressing placement

TARGET AUDIENCE

• Intensive care physicians
• Cardiology and intensive cardiology trainees
• Emergency medicine clinicians
• Anesthesiology professionals
• Critical care fellows and residents
• Clinicians learning ultrasound-guided vascular access
• Medical educators reviewing procedural technique

EDUCATIONAL NOTICE

This content is intended for medical education and procedural review only. It does not replace formal training, institutional protocols, supervision, or clinical judgment. Central venous catheter placement should be performed only by appropriately trained professionals within the scope of local policies and with appropriate safety precautions. Human medical review is mandatory before educational or clinical use.