Clinical note
Real-time ultrasound guided internal jugular vein catheterization in the emergency department

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Abstract

Establishing central intravenous access in the emergency department (ED) is often both crucial and difficult. In patients with nonexistant or ambiguous external anatomic landmarks, a real-time ultrasound guided approach to internal jugular vein cannulation is useful. In addition, the use of ultrasound guidance in internal jugular vein cannulation is supported by reports that have documented reductions in number of cannulation attempts, time required to establish central access, and rate of complications. The use of ultrasound for establishing central venous access has never been described in an ED setting. Two such cases in which ultrasound was extremely helpful for establishing central access in an ED are reported, the techniques employed for real-time ultrasound guidance of internal jugular vein catheterization are described, and the literature that supports the use of this technique is reviewed.

References (14)

  • D Mallory et al.

    Ultrasound guidance improves the success rate of internal jugular vein cannulation

    Chest

    (1990)
  • A Myerson et al.

    Techniques for obtaining blood from the internal jugular vein and internal carotid artery

    Arch Neurol Psychiatry

    (1927)
  • E Gibbs et al.

    Bilateral internal jugular blood

    Am J Psychiatry

    (1945)
  • R Defalque

    Percutaneous catheterization of the internal jugular vein

    Anesth Analg

    (1974)
  • V Puri et al.

    Complications of vascular catheterization in the critically ill

    Crit Care Med

    (1990)
  • G Goldfarb et al.

    Percutaneous cannulation of the internal jugular vein in patients with coagulopathies: An experience based on 1,000 attempts

    Anesthesiology

    (1982)
  • J Ullman et al.

    Internal jugular vein location with the ultrasound Doppler blood flow detector

    Anesth Analg

    (1978)
There are more references available in the full text version of this article.

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