II. Indications

  1. Rapid vascular access in emergency patients

III. Preparation

  1. Bedside Ultrasound
    1. Apply sterile cover to high frequency linear probe
  2. Intravenous catheter
    1. Long peripheral IV: 18 gauge, 14.8 cm catheter over needle OR
    2. Long intravenous catheter from Central Line kit

IV. Technique

  1. Use normal technique for visualizing internal jugular on Ultrasound
  2. Uses limited sterile technique
  3. Site prepped and needle advanced under Ultrasound guidance
  4. Needle retracted once catheter enters internal Jugular Vein
  5. Flush line with Normal Saline

V. Precautions

  1. Remove line after 24-36 hours

VI. Efficacy

  1. Well tolerated procedure, with 88% first attempt success rate, and with mean procedure time of 4.4 minutes
  2. No infections seen in initial study (pending publication)

VII. Resources

  1. Rapid IJ Access demonstration
    1. https://www.youtube.com/watch?v=FjSmbUWXznY

VIII. References

  1. Swaminathan and Orman in Herbert (2016) EM:Rap 16(11): 4

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