View source for The "Easy IJ"

==Overview==
*Alternative to [[Central venous catheterization|CVC placement]] when landmark-based and ultrasound-guided PIV placement has failed
*Relatively new technique
*Does not require full sterile technique (as opposed to traditional CVC placement)

==Indications==
*Patient with difficult vascular access failing ultrasound-guided PIV placement

==Contraindications==
*Thrombosis of the internal jugular vein
*Overlying skin or soft tissue infection

==Equipment Needed==
*Chlorhexidine or alcohol swab
*Ultrasound with high-frequency linear probe
*Bio-occlusive adhesive dressings
*Sterile ultrasound gel media
*Nitrile gloves
*Extra-long 18-gauge intravenous catheter

==Procedure==
*Place patient in Trendelenburg position
*Prep skin with antiseptic
*Apply adhesive dressing to ultrasound probe and cover with sterile gel
*Identify IJV with ultrasound
*Use same technique for [[Ultrasound-assisted peripheral line placement|ultrasound-guided PIV placement]] to cannulate the IJV

==Complications==
*Prospective study of 74 patients in the Emergency Department reported no arterial punctures, infections, or pneumothorax <ref>Moayedi S et al. Safety and Efficacy of the “Easy Internal Jugular (IJ)”: An Approach to Difficult Intravenous Access. J Emerg Med 51(6): 636 – 642. PMID: 27658558</ref>

==See Also==
{{Vascular access types}}

==External Links==
*[http://www.emdocs.net/unlocking-common-ed-procedures-approach-to-the-patient-with-difficult-vascular-access/ emDOCs: Approach to the Patient with Difficult Vascular Access]

===Videos===
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==References==


[[Category:Procedures]]