II. Indications
- Rapid Vascular Access in emergency patients
III. Preparation
-
Bedside Ultrasound
- Apply sterile cover to high frequency linear probe
- Intravenous catheter
- Long peripheral IV: 18 gauge, 14.8 cm catheter over needle OR
- Long intravenous catheter from Central Line kit
IV. Technique
- Use normal technique for visualizing internal jugular on Ultrasound
- Uses limited sterile technique
- Site prepped and needle advanced under Ultrasound guidance
- Needle retracted once catheter enters internal Jugular Vein
- Flush line with Normal Saline
V. Precautions
- Remove line after 24-36 hours
VI. Efficacy
- Well tolerated procedure, with 88% first attempt success rate, and with mean procedure time of 4.4 minutes
- No infections seen in initial study (pending publication)
VII. Resources
- Rapid IJ Access demonstration
VIII. References
- Swaminathan and Orman in Herbert (2016) EM:Rap 16(11): 4