supraclavicular approach to a subclavian line

4 Mar

some nice tips for a less commonly used (but good to know) approach to the subclavian central line.

Some tips from a July EMN article:

 

best with ultrasound

+/- Trendelenburg position

first find the IJ (internal jugular vein)

IJ is compressible; usually oval or triangular (vs the more circular carotid, with its thicker walls)

trace it inferiorly to the supraclavicular fossa, see where it meets the SCV (subclavian vein) — [spare 30 seconds to watch the youtube video below, starting at the 1 min mark, to see this]

AVOID the pulsatile subclavian ARTERY (duh)

in-plane approach is handy, helpful [spare 30 sec to watch this, too, starting at the 2:30 mark]

References: EMN article + picture; youtube video

 

 

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