The "Easy IJ": Difference between revisions
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==Overview== | ==Overview== | ||
*Alternative to [[Central venous catheterization|CVC placement]] when landmark-based and ultrasound-guided PIV placement | *Alternative to [[Central venous catheterization|CVC placement]] when landmark-based and ultrasound-guided PIV placement has failed | ||
*Relatively new technique | *Relatively new technique | ||
*Does not require full sterile technique (as opposed to traditional CVC placement) | *Does not require full sterile technique (as opposed to traditional CVC placement) | ||
Revision as of 01:19, 22 November 2020
Overview
- Alternative to CVC placement when landmark-based and ultrasound-guided PIV placement has failed
- Relatively new technique
- Does not require full sterile technique (as opposed to traditional CVC placement)
Indications
- Patient with difficult vascular access failing ultrasound-guided PIV placement
Contraindications
- Thrombosis of the internal jugular vein
- Overlying skin or soft tissue infection
Equipment Needed
- Chlorhexidine or alcohol swab
- Ultrasound with high-frequency linear probe
- Bio-occlusive adhesive dressings
- Sterile ultrasound gel media
- Nitrile gloves
- Extra-long 18-gauge intravenous catheter
Procedure
- Place patient in Trendelenburg position
- Prep skin with antiseptic
- Apply adhesive dressing to ultrasound probe and cover with sterile gel
- Identify IJV with ultrasound
- Use same technique for ultrasound-guided PIV placement to cannulate the IJV
Complications
- Prospective study of 74 patients in the Emergency Department reported no arterial punctures, infections, or pneumothorax
References
1. Moayedi S et al. Safety and Efficacy of the “Easy Internal Jugular (IJ)”: An Approach to Difficult Intravenous Access. J Emerg Med 51(6): 636 – 642. PMID: 27658558