Overview of Scalp Catheterization

When someone needs to be quickly treated in a medical emergency, a process called peripheral venous access is often used. This is a method in which a small tube, known as a catheter, is inserted into a vein in the body so that medicines, fluids, or other treatments can be directly delivered into the bloodstream. This can be done on patients of any age.

For young children, including babies and infants, the best spots to insert the catheter are normally the hands, feet, forearms, and scalp. These areas are usually easier to access and doing so means less risk for the child.

The reason for using a catheter in infants can vary. It could be used for routine needs like giving the baby fluids to keep them hydrated, supplying blood or blood products, administering medication, or feeding the baby when they can’t eat by mouth.

In some instances, especially in newborns and infants, a vein in the scalp may be used for catheterization. This is usually done when attempts to insert the catheter in the arm or leg have not been successful. The veins in the scalp are relatively easy to access and stabilize, and they are usually a better choice in these cases because, unlike other areas, the scalp has less fat covering the veins. This allows doctors to see the veins more clearly and makes it easier to insert the catheter.

Please refer to the attached image to get a visual idea of how scalp veins are used for catheterization in babies.

Anatomy and Physiology of Scalp Catheterization

The veins in the face and scalp of babies and young children are quite noticeable. They don’t have valves and are only lightly covered by fine hair. The most commonly visible veins are the ones on the forehead, around the ears, on the sides of the head, and at the back of the head.

The vein on the side of the head, known as the superficial temporal vein, carries blood from the entire side region of the head. This vein then joins another one near the jaw to form the retromandibular vein. From there, the blood flows into a larger vein in the neck, known as the external jugular vein.

The veins on the forehead, known as the frontal and supratrochlear veins, carry blood from the front part of the head that’s between your eyebrows and the top of your head. They carry the blood to the inside corner of the eye, where they join another vein to form the angular vein. This vein is connected to veins inside the head, and the blood eventually flows into the facial vein and then into another large vein in the neck, known as the internal jugular vein.

The occipital vein carries blood from the back of the head. It pushes through the muscles at the back of the neck and drains directly into the internal jugular vein or through a vein near the ear.

Lastly, the veins around the ear, known as the auricular veins, carry blood from areas in front of and behind the ear. They drain the blood into the external jugular vein in the neck.

Why do People Need Scalp Catheterization

When young patients need to receive medicines or fluids directly into their veins and it’s hard to access veins in their arms or legs, doctors may use a procedure called scalp vein cannulation. This involves putting a small tube into veins located in the scalp. It’s a safe and effective way to ensure these young patients get the treatment they need.

When a Person Should Avoid Scalp Catheterization

There are some reasons why a doctor might not want to place a cannula (a tiny tube for giving medicine or drawing blood) in an older baby’s scalp vein (a vein in the head):

– The cannula might get knocked out easily.

– If there are skin problems in the area or signs of infection, it’s best to avoid the procedure.

Equipment used for Scalp Catheterization

When a doctor performs a scalp cannulation, which is a procedure where a small tube is inserted into a vein in the scalp, they need certain items:

  • A very small catheter, which is a flexible tube to go into the vein. This is often called a butterfly or scalp vein set and is usually just 3/4 inch long. They will choose the smallest tube available, which could be 23-, 25-, or 27-G (G stands for gauge, a measure of thickness).
  • A 24-G catheter-over-needle can also be used. This is a type of catheter mounted over a needle, but it would need extra tubing.
  • An elastic band tourniquet. This is a band tied around the wound to stop blood flow.
  • Alcohol, or other skin preparation substances, to clean the skin before surgery.
  • Clear tape, to fix the catheter in place.
  • A clear adhesive bandage, to protect the wound after the catheter is in place.
  • Saline flushes, which are salt water solutions used to clean out the catheter.
  • A clear plastic cup. This is optional and can be used for various purposes during the procedure.

Who is needed to perform Scalp Catheterization?

Putting a small tube (catheter) into a vein in the scalp, usually to give medicine or fluids, is typically done by a doctor. However, a nurse who has been specially trained and has experience in the unit for newborns who need extra care (NICU) can also do this procedure.

Preparing for Scalp Catheterization

It’s often beneficial to have another person around when a medical procedure is being conducted on a child. This person can help hold the child steady during the process. Having a parent present can also be of great comfort to the child.

Additionally, using a ‘papoose’ (a kind of swaddling blanket) can help to gently restrict the child’s arm movements, particularly if there’s no one else there to assist. This is important in making sure the procedure goes smoothly.

The healthcare professional who is administering the procedure should be positioned at the top of the bed. This gives them easier access to the child’s head if they need it.

Finally, a simple way to help calm the child is to place a drop of oral sucrose (a type of sugar) or give them a pacifier. This small step can have a calming effect on the child during the procedure.

How is Scalp Catheterization performed

Veins are often easy to see and can be made to stand out even more by getting the infant to cry and applying gentle pressure at the base of the vein. Suitable veins include the superficial temporal, frontal, occipital, and ones located before and behind the ear. It’s essential to tell the difference between arteries and veins because the scalp has many arteries and veins. Knowing the difference can be challenging until the needle puncture is done. If an artery is accidentally punctured, the needle must immediately be removed and pressure applied to the site.

To make the scalp veins stand out more, place a rubber or elastic band above the ears and eyes on the patient’s scalp. Make sure the band isn’t too tight, as indicated by red or purplish skin. Choosing areas behind the hairline may result in less noticeable scars in the future. A straight vein is best for inserting a catheter. Clean the area with alcohol or special skin cleanser before the surgery. You may also have to shave nearby areas of hair for a clearer view and to properly secure the catheter. Hold the vein steady with your non-dominant hand while you insert the needle. A noticeable return of blood or a “pop” sound might not occur when accessing veins in young children.

Gently insert the needle in the same direction of the vein at an angle of 20 to 30 degrees above the skin until you see blood in the chamber. At this point, you can remove the tourniquet. Next, push the needle slightly further in to make sure it is in the vein. Let the baby calm down before you thread the catheter into the vein. This can help to prevent the vein from spasming. To check the catheter’s position, inject a small amount of salt water solution. If the saltwater flushes easily and the area around the needle doesn’t start to swell, you can secure the catheter.

To keep the catheter from pressing on the skin, place a small piece of rolled gauze under the catheter hub. Cover the hub site with a clear, sticky dressing, then stick several pieces of tape in a crisscross or “H” pattern to hold the device in place. Also, tape a loop of the loose tube close by so that if it gets pulled, the loop can give way before the needle. Some suggest taping a clear, plastic cup, cut in half, over the site for added protection. You can cut the base of the cup to form a hinge for easier access.

Possible Complications of Scalp Catheterization

Air can sometimes accidentally get into the veins in the scalp during a procedure because scalp veins don’t have valves to block it. This can be very dangerous, so it’s important not to inject air into the catheter in the scalp vein and not to leave it open to the air if the patient’s head is raised. To prevent this, the patient should be lying down flat or slightly tilted downwards during daily catheter care. Once the catheter is taken out, a bandage that blocks air should be put on the site.

Infections could happen at the spot where a needle punctures the skin if the area is not cleaned well before the needle is put in or if the needle stays in for too long. Studies show that it may take up to 6 days for bacteria to start growing on an intravenous (IV) line in children. An IV line that is put in a vein in the arm or leg (peripheral) might be a better option if the patient needs IV treatment for more than a week.

Needles that go into scalp veins might not lead to as many infections as plastic tubes placed into the veins. When it comes to infection rates, Teflon tubes have the highest. Other possible issues that could arise (though rare) include pimples on the scalp, hair loss, brain abscesses, inflammation and clotting in the veins, and a severe skin infection called necrotizing fasciitis in the scalp.

What Else Should I Know About Scalp Catheterization?

Using the veins in your scalp to place a catheter (a thin tube that allows for the delivery or removal of fluids) can be done without higher risk of complications compared to placing it in other parts of your body. This procedure is known as a peripherally inserted venous catheter.

Frequently asked questions

1. What are the potential risks and complications associated with scalp catheterization? 2. How long will the catheter need to remain in place, and what are the steps for proper care and maintenance? 3. Are there any specific signs or symptoms I should watch out for that may indicate an infection or other complications? 4. How will the scalp catheterization procedure be performed, and what can I expect during and after the procedure? 5. Are there any alternative options or considerations for administering medications or fluids if scalp catheterization is not possible or recommended?

Scalp catheterization is a medical procedure that involves inserting a catheter into the veins of the scalp. This procedure can be used to administer medication or fluids, monitor blood flow, or collect blood samples. It may cause some discomfort or pain, but it is generally a safe and effective procedure when performed by a trained healthcare professional.

Scalp catheterization may be necessary in certain situations where a doctor does not want to place a cannula in an older baby's scalp vein. This could be due to the cannula being easily knocked out or if there are skin problems or signs of infection in the area.

A doctor might not want to place a cannula in an older baby's scalp vein due to the risk of the cannula getting knocked out easily and if there are skin problems or signs of infection in the area.

The text does not provide information about the recovery time for Scalp Catheterization.

To prepare for scalp catheterization, the patient should have a small catheter, elastic band tourniquet, alcohol or skin preparation substances, clear tape, clear adhesive bandage, saline flushes, and a clear plastic cup. The healthcare professional should position themselves at the top of the bed for easier access to the child's head. To calm the child, a drop of oral sucrose or a pacifier can be used.

The complications of Scalp Catheterization include accidental injection of air into the veins, which can be dangerous, and the risk of infection at the puncture site if the area is not properly cleaned or if the needle remains in for too long. Other potential complications include pimples on the scalp, hair loss, brain abscesses, inflammation and clotting in the veins, and a severe skin infection called necrotizing fasciitis in the scalp.

There are no specific symptoms mentioned in the text that would require scalp catheterization. Scalp catheterization is used when it is difficult to access veins in the arms or legs of young patients who need to receive medicines or fluids directly into their veins.

The provided text does not mention anything about the safety of scalp catheterization in pregnancy. Therefore, it is not possible to determine the safety of scalp catheterization in pregnancy based on the given information. It is recommended to consult with a healthcare professional for specific advice regarding scalp catheterization during pregnancy.

Join our newsletter

Stay up to date with the latest news and promotions!

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

We care about your data in our privacy policy.