Suggested changes in central venous cannulation

Abstract

Use of ultrasound (US) is standard of care these days for central venous access[1]. Traditionally, a 22 or 25 gauge seeker needle (injection) was used to locate the internal jugular vein. After the introduction of US in clinical practice introducer needles are now used alone for localization and threading guide wires into central veins. In our University-hospital based Department, Arrow^®triple lumen catheter sets are being used, containing an 18G 2.5″ (6.35 cm) needle as introducer. Approximately two thousand central lines are placed under US annually and our faculty has largely discarded the practice of using seeker needles. The depth and coordinates^3,4 of internal jugular vein are estimated by using the calibrated view on the display screen of the ultrasound machine.