Standards Procedure (Skill)
Clinical Indications: Levels: EMT-I & EMT-P
Ø External jugular vein cannulation is indicated in a critically ill patient > 8 years of age who requires intravenous access for fluid or medication administration and in whom an extremity vein was not attainable.
Ø External jugular cannulation can be attempted initially in life threatening events where no obvious peripheral site is noted.
Procedure:
a. Place the patient in a supine position. This helps to distend the jugular veins and reduces the possibility of an air embolism.
b. Turn the patient’s head toward the opposite side if there is no possibility of cervical spine injury.
c. Prep the selected site as per peripheral IV site.
d. Align the catheter with the vein and aim in a caudal position (toward the clavicle).
e. Lightly place a finger just above the clavicle to produce a “tourniqueting” effect. Puncture the vein midway between the angle of the jaw and the clavicle and cannulate the vein in the usual manner.
f. Attach an IV line and secure the catheter avoiding circumferential dressing or taping.
g. Assure patency of the line.
h. Document the procedure, time, and results on the ACR.
Certification Requirements:
Successfully complete an annual skill evaluation including the indications, contraindications, technique, and possible complications of the procedure.