critical care medicine
How To Do Internal Jugular Vein Cannulation
Warnings and Common Errors
The tip of a CVC must never lie in the right atrium because the atrium is thin-walled and easily perforated. Cardiac ectopy may be induced by a guidewire or catheter in the right atrium or ventricle. Never lose grasp of the guidewire. 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. To help prevent air embolism, CVCs should be inserted (and removed) with the vascular cannulation site positioned dependant to the heart. 