critical care medicine
How To Do Internal Jugular Vein Cannulation
Equipment for Internal Jugular Vein Cannulation
Antiseptic solution (eg,chlorhexidine-alcohol,chlorhexidine, povidone iodine, alcohol) Large sterile drapes, towels Sterile head caps, masks, gowns, gloves Face shields Cardiac monitor Local anesthetic (eg, 1%lidocainewithoutepinephrine, about 5 mL) Small anesthetic needle (eg, 25 to 27 gauge, about 1 inch [3 cm] long) Large anesthetic/finder* needle (22 gauge, about 1.5 inches [4 cm] long) Introducer needle (eg, thin-walled, 18 or 16 gauge, with internally beveled hub, about 2.5 inches [6 cm] long) 3- and 5-mL syringes (use slip-tip syringes for the finder and introducer needles) Guidewire, J-tipped Scalpel (#11 blade) Dilator Central venous catheter (adult: 8 French or larger, minimum length for internal jugular catheter is 15 cm for right side, 20 cm for left side) Sterile gauze (eg, 4 × 4 inch [10 × 10 cm] squares) Sterile saline for flushing catheter port or ports Nonabsorbable nylon or silk suture (eg, 3-0 or 4-0) Chlorhexidinepatch, transparent occlusive dressing * A finder needle is a thinner needle used for locating the vein before inserting the introducer needle. It is generally recommended for nonultrasound–guided internal jugular vein cannulation. Having an assistant or two is helpful. 