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Ultrasound-Guided Internal Jugular Access^*

A Proposed Standardized Approach and Implications for Training and Practice

^* From the Medical Procedure Service, Harvard Medical School, Boston, MA.

Correspondence to: David Feller-Kopman, MD, FCCP, Interventional Pulmonology, Beth Israel Deaconess Medical Center, One Deaconess Rd, Suite 201, Boston, MA 02215; e-mail: dfellerk{at}bidmc.harvard.edu

Abstract

In 2001, the Agency for Healthcare Research and Quality recommended the use of ultrasound for the placement of central venous catheters (CVCs) as one of their 11 practices to improve patient care. These recommendations were based on the results of several randomized clinical trials showing significantly improved overall success as well as reductions in complications. This article will describe the practical aspects of using ultrasound to guide placement of CVCs in the internal jugular vein in a "how I do it" approach, as well as review the practice management and training aspects related to incorporating ultrasound into daily practice.

Key Words: central venous catheter • complications • internal jugular vein • outcomes • ultrasound

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