How to Safely Cannulate a Difficult Internal Jugular Vein on the First Attempt

Indeed, checking blood return is an essential procedure in CV line placement. But, putting too much priority on flashback can hamper efforts to visualize the needle tip on US screen. For a deeper insight into this topic, please go to https://doi.org/10.1186/s41100-016-0019-1 and view my article: “Ultrasound-guided cannulation of hemodialysis access”.

A nephrologist in Kyoto, Tadashi Kamata, MD

Video Index: Click on the blue type below to jump to a specific stage of the video.
00:00 Start
1. 00:16 Background
2. 01:10 Transverse vs. longitudinal
3. 01:32 Probe holding
4. 02:31 Needle holding
5. 02:54 Determination of puncture site
6. 04:20 In the soft tissue
7. 07:09 Push & stick
8. 09:33 Needle blinking
9. 11:36 Guidewire identification
10. 12:30 Actual case
11. 17:20 Difficult cases
12. 20:26 Troubleshooting
13. 21:30 Needle
14. 22:49 Guidewire
15. 23:05 Ultrasound machine
16. 23:40 Simulation training
17. 24:00 Video recording

*************** Relevant papers & videos ***************
Three tips for improving the ultrasound visibility of the needle tip.
https://youtu.be/7fxADjLICQ0

Thomas S, et al. “The vanishing target sign: confirmation of intraluminal needle position for ultrasound guided vascular access.” Acad Emerg Med. 2013 Oct;20(10):e17-8. https://onlinelibrary.wiley.com/doi/epdf/10.1111/acem.12228

Bondestam S. “The needle tip echo.” J Ultrasound Med. 1992;11:253-6

Kamata T, et al.“Ultrasound-guided cannulation of hemodialysis access. Ren Replace Ther” 2016; 2:7 https://doi.org/10.1186/s41100-016-0019-1

Kamata T, et al. “Visibility of guidewires in ultrasound-guided internal jugular double lumen catheterization” J Jpn Soc Dial Ther. 2012;45:475–82 (in Japanese). https://www.jstage.jst.go.jp/article/jsdt/45/6/45_475/_pdf

Ultrasound Guided Internal Jugular Vein Cannulation NEJM
https://youtu.be/hPPzFnGcLRs

Rapid IJ (aka Easy Internal Jugular Cannulation)
https://youtu.be/FjSmbUWXznY

Internal jugular central line insertion
https://youtu.be/fZyxzzn11QM

Ultrasound-guided internal jugular cannulation (short-axis approach)
https://youtu.be/PUyybCfli_E

Ultrasound Guided Subclavian Central Lines -- BAVLS
https://youtu.be/_VYHj4sRlkc

Ultrasound guided peripheral venous cannulation in an actual patient
https://youtu.be/8FnyzJzDYds

Видео How to Safely Cannulate a Difficult Internal Jugular Vein on the First Attempt канала Ultrasound instruction video