Easy Internal Jugular (IJ)
- placement of single-lumen catheter into IJ using ultrasound guidance
- in a prospective study by Moayedi et al. 2016, 83 attempts recorded in 74 patients with initial success rate 88% and mean procedure time 4.4 min; complications included loss of patency in 14% (95% CI 7 - 24%), and 0/83 with pneumothorax, line infection, arterial puncture
Indications
- patients who do not require triple lumen catheter but with difficulty in obtaining peripheral access
Materials
- ultrasound with linear probe
- chlorhexidine
- 18-gauge catheter at least 2 inches long
- sterile probe cover
- sterile lubricant
- sterile gloves
Procedure
- similar to ultrasound-guided peripheral IV placement
- increased success may be achieved with Trendelenburg position and Valsalva maneuver with head turned toward opposite side of target vein
- does not require full sterile drape or gown
Post-procedure Recommendations
- may check CXR to r/o pneumothorax
- intended for 24 hour use, but may be left in longer, up to 7 days in some studies
Resources
Butterfield M et al. Using Ultrasound-Guided Peripheral Catheterization of the Internal Jugular Vein in Patients with Difficult Peripheral Access. Am J Ther 2015. PMID 26469683
Moayedi S et al. Safety and efficacy of the “easy internal jugular (IJ)”: an approach to difficult intravenous access. J Emerg Med. 2016; 51(6): 636-642. PMID 27658558