How to: Ultrasound Guided Internal Jugular Central Line
A training video demonstrates ultrasound-guided insertion of an internal jugular venous catheter using a linear array transducer with a venous examination preset, performed in a transverse approach with the patient supine and head turned contralaterally, and the operator positioned at the head of the bed with the probe placed below the sternocleidomastoid triangle and oriented marker at the 9 o’clock position. Ultrasound identification shows the sternocleidomastoid muscle as the most superficial structure, with the internal jugular vein appearing as a compressible anechoic elliptical structure located superficial to the carotid artery, which appears more circular and pulsatile, while the thyroid gland lies medially with a lighter grey echotexture, helping differentiate surrounding vascular anatomy. Real-time needle guidance is performed by advancing the needle just superior to the transducer, visualizing it as a bright dot, intermittently sliding the probe to relocate the tip, and repeatedly advancing under direct ultrasound visualization to maintain tip tracking throughout progression.
