Ultrasound-assisted internal jugular vein catheterization in the ED

A prospective, descriptive study is reported on the use and success of ultrasound-assisted internal jugular central vein catheterization (CVC) in the emergency department (ED). In patients not in cardiac arrest who had an indication for internal jugular CVC, lines were placed by trained ED staff using ultrasound. Data were collected prospectively on age, sex, body habitus, indication, vein visibility, number of punctures and needle passes, and success. There were 40 attempts at internal jugular CVC in 34 patients and ultrasound was used in 32 of the 40 (80%) attempts. Incidences of successful puncture and cannulation using ultrasound were 93.8% (30 of 32) and 81.3% (26 of 32), respectively, compared with 62.5% (5 of 8) and 62.5% (5 of 8) in the landmark group. In 8 patients with no visual or palpable landmarks, cannulation was successful in 100% (7 of 7) using ultrasound and in 0% (0 of 1) using landmark technique. Ultrasound-assisted internal jugular CVC is an easily learned technique that is useful in the ED. It may be especially helpful in patients in whom landmarks are not visible and not palpable.