How to: Internal Jugular and Needle Insertion for Vascular Access with Ultrasound

This video discusses some of the scanning techniques and anatomy landmarks seen when performing internal jugular vein vascular access, including patient position, transducer position, identification of structures near the vein, vein depth, and insertion technique.
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[@cardiocrit1259]

This video is an OG" thank you for the production and the person behind it

[@ejajuddinahmed7342]

I have seen many videos of this procedure. This was the most helpful one

[@InfinityFishing]

very good presentation how to guide your transducer to track the needle tip

[@aleksandrtkachuk6712]

I started to use US-guidance about a half-year ago and I think it's very useful. Now I choose subclavicular vein for hi-emergency situations only, and when I have alittle more time - I take our US-machine. My experience is not so extensive, but I think that all urgent-physicians can use US (for needle navigation, or for IVC/FAST/FOCUS-assessment) to increase patients' benefit.

[@lillybye1]

Thank you doc

[@ivanvelazquezfiesco8583]

EXCELENTE!!!!!

[@drktp6772]

Awesome!

[@shilpinsolanki482]

Very nice presentation Sir

[@drgadham]

Good demo

[@WilliamBrownGuitar]

I question the "ultrasound is much safer for central line placement" statement. I sense a huge push for ultrasound use and it's being made a "standard" coming from the manufacturers and the physicians who are employed by them. In experienced hands central line placement is fast and extremely safe, without an ultrasound machine.
I see a role for U/S perhaps in cases of distorted anatomy or to diagnose thrombosis.

[@Sonosite]

Thank you for your thoughts, William. You might be interested in checking out some of the non-biased resources out there as to the value of ultrasound guidance with respect to patient safety and avoidance of complications.
"...data suggest that ultrasound-guided catheterisation of the IJV in critical care patients is superior to the landmark technique..." bit.ly/1pBaz8A
"Evidence supports the use of two dimensional ultrasonography for central venous cannulation." 1.usa.gov/1e5KDuJ
"ultrasound guidance...improves success rates and decreases the complications associated with...[IJV] catheter placement. 1.usa.gov/1liXNtr
AHRQ Analysis: Chapter 18 focuses on ultrasound guidance for central line insertion. 1.usa.gov/1fHRaw0

[@mana5280HQ]

William Brown how would you know if someone's anatomy is distorted if you're not using US? Lots of literature out there to support US and many medical organizations have adopted US as standard of care.

[@mainakdeb8322]

Data needs to be converted into intelligence.. otherwise it is useless or worse..errant. No doubt us guidance is better than any landmark technique, but standards are set keeping the benefit vs cost ratio in consideration.. not benefit alone. Making it a standard means unwelcome medicolegal fuss in most of the world who cannot conform to this ' standard' of care. It also means denying young intesivists the training of blind technique. I would hate to see them watch patients die as the machine boots up.. and about the ' much safer ' part.. can someone calculate the NNT ( number needed to treat) to make a difference? I dont know.. but my guess is it is going to be huge..thoughts from india