Which of the following are vessels that often require a surgical cut down when used for pulmo-nary artery catheter access? 1. Femoral vein 2. Subclavian vein 3. Internal jugular vein 4. Antecubital vein

a. 1 and 2 only
b. 1 and 4 only
c. 2 and 4 only
d. 2 and 3 only

ANS: C
The subclavian, internal jugular, external jugular, femoral, or antecubital veins may be used for access for pulmonary artery catheters. A surgical cut down is often necessary when the subclavi-an or antecubital veins are used. This is done so that the vein may be visualized directly to facili-tate catheter entry. It is especially useful in cases of hypovolemic shock and trauma when periph-eral cannulation is difficult or impossible.