External Jugular Venous Catheter

5/6/03 version

 

The external jugular vein is a peripheral vein that generally is neither collapsed (with a patient in a Trendelenberg position) nor thrombosed. This site is often difficult for the patient because the catheter entrance and the dressing are on the patient's neck. The external jugular vein may be the site of last resort when a patient needs peripheral access but other veins are not usable. The external jugular vein may be used for non-sclerosing fluid administration. Note that, as with other IV sites, shorter catheters of a given caliber can deliver more fluid than a longer catheter, and shorter catheters may be preferred in the situation where large amounts of fluid are being given emergently.

 

Indications:

 

Contraindications:

 

Materials:

 

Preprocedure patient education:


Procedure:

        For an additional check to ascertain good flow into the vein, remove the IV solution from the pole and lower the bag below the level of the patient to establish that there is blood return from the vein.

        Return the solution bag to the IV pole and regulate the flow of the fluid as necessary.

 

Complications, Prevention and Management:

        Local hematoma

o       Prevention: going too deep might lacerate the deep wall of the vein or too superficially the superficial wall of the vein. To prevent this, take care to strictly follow the axis of the vein during insertion.

o       Management: Local pressure (but never circumferentially applied)

        Laceration of the deeper internal jugular vein

o       Prevention: Do not insert the needle deeply for this procedure

o       Management: Local pressure as above

        Infection:

o       Prevention: Sterile procedure, and never through infected skin

o       Management: Appropriate antibiotics

        Air embolism


Documentation in the medical record:

used including prep, anesthetic, type of needle

 

Helpful hints:

 

Items for evaluation of person learning this procedure:

 


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