The femoral site is sometimes preferable in critically ill patients because the groin is free of other resuscitation equipment and devices which may be required for monitoring and airway access. Central venous access in the common femoral vein offers the advantage of being an easily compressible site, which may be helpful in trauma and other coagulopathic patients.[25] Additionally, unlike the IJ and SC sites, iatrogenic pneumothorax is not a concern. Patients may be more comfortable with a femoral CVC because it allows relatively free movement of the arms and legs compared to other sites. However, femoral CVCs are typically associated with increased thrombotic complications and likely an increased rate of catheter-associated infections. However, studies have shown conflicting results about the real risk of infection when the proper sterile technique is used.[5][26][27][28] Unlike IJ or SC lines, femoral central lines do not allow for accurate measurement of central venous pressure (CVP), though this is not important in every clinical scenario. The common femoral vein is located within the femoral triangle. This region is outlined by the adductor longus medially, sartorius muscle laterally, and the inguinal ligament superiorly. There are important anatomical considerations to keep in mind when accessing this particular site. Whereas in the neck, the (carotid) artery is medial to the (internal jugular) vein, the artery is lateral to the vein in the leg. The mnemonic NAVEL is useful for recalling the order of lateral to medial structures: femoral nerve, femoral artery, common femoral vein, "space" (femoral canal), and lymphatics.[29] Knowing this anatomy or landmark-guided central line placement band is important because ultrasonography may appear similar.[11]
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