W3 Central Venous Catheterization
Before Procedure
Indications
Anatomy
Procedure
• Internal jugular vein (middle approach):
• Perform nonsterile ultrasound to confirm patency and depth of internal jugular vein and location of surrounding structures.
• Use 2% chlorhexidine prep stick to prep area bounded by ear lobe, mandible, chin, neck, and sternal notch past midline, 2 cm inferior to clavicle and 2 cm posterior to sternal head of SCM muscle.
• Find anatomic landmarks: apex of triangle formed by two heads of SCM muscle, sternal notch, clavicle, carotid pulse.
• Locate internal jugular vein with ultrasound probe, and confirm that it collapses easily with compression and is nonpulsatile.
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