Page 235 - 2023 SMOG Digital

VASCULAR ACCESS via
External Jugular Vein Cannulation

CLINICAL INDICATIONS:
• In the presence of a life threatening condition, with clear indications for immediate use of
medication, blood or fluid bolus. It should only be used when a peripheral IV site cannot be
established (Not for prophylactic IV access.)
CONTRAINDICATIONS:
• Inability to obtain any other suitable peripheral IV access
• Administer IV fluids or blood
• Administer medications
Equipment:
• IV start kit (alcohol swabs 4 x 4s, tourniquet, tape)
• Large bore IV catheter (14 or 16 gauge)
• IV fluid tubing
PROCEDURE:
• Explain the procedure to the patient
• Select the insertion site
• Find the landmarks midway between the angle of the jaw and the midpoint of the clavicle.
• Turn the patient’s head away from the intended site of insertion. Consider placing the patient in the
Trendelenburg position or holding the thumb over the vein to facilitate insertion.
• Insert the IV catheter pointing towards the ipsilateral acromioclavicular joint until a flash fills the
chamber of the catheter, then advance the catheter over the stylet and remove the stylet.
• Attach the IV fluids to the catheter and infuse to verify the intravenous line is patent and dose not
infiltrate.
• Secure the IV catheter using tape and a Tegaderm dressing or a clear occlusive dressing.
• Dispose of sharps in an approved biohazard container.
• Document procedure, results, and vital signs.
Complications:
• Infiltration
• Hematoma formation
• Cellulitis/infection
• Thrombosis
• Phlebitis

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