Ether Resources for Anesthesia Research and Education

Ultrasound-guided Internal Jugular Catheterization

Table of Contents

Demonstration of the Central Line Kits:

Quicktime Version (Movie, Requires Apple Quicktime)

Quicktime Version (Movie, Requires Apple Quicktime)

Important teaching points:

  1. Indentification of both the internal jugular vein (patent, collapsable with probe pressure and absence of clot) AND carotid artery (strong pulsations on probe pressure)
  2. Use of the needle guide to control the position of the needle at all times (the guide keeps the needle in the midline, and directs the needle angle so that the needle tip is visible at the moment of vessel puncture)
  3. Visualization of vessel puncture
  4. Release of needle from Sonosite needle guide (needle guide design vary with each ultrasound device)
  5. Using ultrasound for confirmation of proper guidewire placement  in the jugular vein BEFORE dilation and catheter placement

Does the guidewire ENTER the correct vessel?

Does the guidewire REMAIN in the correct vessel?  (i.e., does it go through the back wall of the correct vessel into some other place?)

  1. Clamping guidewire BEFORE advancing dilator
  2. Using free hand to provide counter-traction
  3. Clamping guidewire BEFORE advancing catheter over guidewire into the patient
  4. Announce ‘Guidewire is out’ (if more than one kit is open, announce that all guidewires are out and accounted for)

Demonstration of the Ultrasound-guided Internal Jugular Catheterization:

Quicktime Version (Movie, Requires Apple Quicktime)

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