critical care medicine
How To Do Internal Jugular Vein Cannulation
Additional Considerations
Cannulation attempts sometimes fail. Do not exceed 2 or 3 attempts (which increases the risk of complications), and use new equipment with each attempt (ie, do not re-use needles, catheters, or other equipment because they may have become blocked with tissue or blood). During cardiopulmonary arrest, or even low blood pressure and hypoxia, arterial blood may be dark and not pulsatile and may be mistaken for venous blood. If the internal jugular artery is errantly cannulated by either the tissue dilator or the CVC, leave the dilator or catheter in place and obtain surgical consultation for possible surgical removal. 