A 28 year female patient was admitted with fever of five days duration and difficulty to breathe since one day. On physical examination, she was in respiratory distress, requiring oxygen supplementation. Her heart rate was 120 beats/ min, radial pulse was feeble, blood pressure 80/40 mmHg, respiratory rate 30/min, and SpO 2 85%.
Multiple attempts at peripheral vein cannulation had failed. A right sided subclavian vein catheter was planned in view of her general condition and need for fluid and inotropic support. A 15 cm 7 Fr triple lumen central venous catheter was inserted into the right subclavian vein using the Seldinger technique on first attempt with no difficulty. A good back flow of blood was also confirmed. Quick look at the post procedure chest radiograph confirmed the position of the catheter and absence of pneumothorax [Figure 1]. Initial central venous pressure (CVP) tracing could not be obtained due to non availability of a transducer. On connecting the intravenous (IV) fluid infusion to one of the lumens of CVP catheter, there was no free flow of the IV fluid.
