critical care medicine
How To Do Infraclavicular Subclavian Vein Cannulation, Ultrasound Guided
Introduction
Ultrasound-guided cannulation of the subclavian vein uses real-time (dynamic) ultrasound to guide venipuncture and a guidewire (Seldinger technique) to thread a central venous catheter through the subclavian vein and into the superior vena cava. Two approaches (infraclavicular and supraclavicular) are used; the infraclavicular approach is described here. Using ultrasound guidance to approach the subclavian vein infraclavicularly requires that the axillary vein (distal continuance of the subclavian vein) is imaged and cannulated because the clavicle blocks ultrasound imaging of the proximal vein. Cannulating the axillary vein may be difficult to do with or without ultrasound guidance, and ultrasound guidance, if available, is mandatory. (See also Central Venous Catheterization , 