How to Safely Cannulate a Difficult Internal Jugular Vein on the First Attempt

Indeed, checking blood return is an essential procedure in CV line placement. But, putting too much priority on flashback can hamper efforts to visualize the needle tip on US screen. For a deeper insight into this topic, please go to doi.org/10.1186/s41100-016-00... and view my article: “Ultrasound-guided cannulation of hemodialysis access”.
A nephrologist in Kyoto, Tadashi Kamata, MD
Video Index: Click on the blue type below to jump to a specific stage of the video.
00:00 Start
1. 00:16 Background
2. 01:10 Transverse vs. longitudinal
3. 01:32 Probe holding
4. 02:31 Needle holding
5. 02:54 Determination of puncture site
6. 04:20 In the soft tissue
7. 07:09 Push & stick
8. 09:33 Needle blinking
9. 11:36 Guidewire identification
10. 12:30 Actual case
11. 17:20 Difficult cases
12. 20:26 Troubleshooting
13. 21:30 Needle
14. 22:49 Guidewire
15. 23:05 Ultrasound machine
16. 23:40 Simulation training
17. 24:00 Video recording
************** Relevant papers & videos **************
Three tips for improving the ultrasound visibility of the needle tip.
• Three tips for improvi...
Thomas S, et al. “The vanishing target sign: confirmation of intraluminal needle position for ultrasound guided vascular access.” Acad Emerg Med. 2013 Oct;20(10):e17-8. onlinelibrary.wiley.com/doi/e...
Bondestam S. “The needle tip echo.” J Ultrasound Med. 1992;11:253-6
Kamata T, et al.“Ultrasound-guided cannulation of hemodialysis access. Ren Replace Ther” 2016; 2:7 doi.org/10.1186/s41100-016-00...
Kamata T, et al. “Visibility of guidewires in ultrasound-guided internal jugular double lumen catheterization” J Jpn Soc Dial Ther. 2012;45:475-82 (in Japanese). www.jstage.jst.go.jp/article/...
Ultrasound Guided Internal Jugular Vein Cannulation NEJM
• Ultrasound Guided Inte...
Rapid IJ (aka Easy Internal Jugular Cannulation)
• Rapid IJ (aka Easy Int...
Internal jugular central line insertion
• Internal jugular centr...
Ultrasound-guided internal jugular cannulation (short-axis approach)
• Ultrasound-guided inte...
Ultrasound Guided Subclavian Central Lines -- BAVLS
• Ultrasound Guided Subc...
Ultrasound guided peripheral venous cannulation in an actual patient
• Ultrasound guided peri...

[@123456789Skiing]

Everyone teaches the steps but rarely anyone explains the troubleshooting. This is the only video that I found helpful in those terms. Thank you so much!

[@ultrasoundinstructionvideo7767]

Hi, Hasan!　You have rightly pointed out the importance of troubleshooting. Thank you．

[@naw4197]

Probably the best tutorial I’ve ever seen on ultrasound guided cannulation.

[@khoaphan2203]

Thanks for producing such a detailed and whole-hearted video.

[@deepalazarous]

This is one of the best teaching videos I have come across

[@mohammedabdulaaima9031]

Best video I've seen in a long time, I appreciate the efforts, hard work and time you put into this masterpiece. Thank you

[@ultrasoundinstructionvideo7767]

Thanks a million for your kind remark!

[@zumanjee]

Excellent and very thorough step by step video!! One of the best out there!! Very helpful!! Thank you!!!

[@mohamedelrazi2880]

A wesome. I was searching for such nice video since long time. It is very helpful and informative . It's the best ever in RUclips.. Thank you very much.

[@ultrasoundinstructionvideo7767]

Thank you for the favorable comment. It was very encouraging for me.

[@sheklym]

Thank you, very informative and useful video

[@tl854393]

Thank you so much. From Vietnam.

[@jonchoi1233]

I wish central line manufacturers would make all introducer needles more radio opaque.

[@zhangcd07]

Best video!

[@No-xh2cs]

Thank you for this amazing video. I think everyone should watch it especially the ones that poke blindly even when they use an ultrasound

[@elliottsmith1548]

very nice

[@jonodee]

Jedi level stuff - thanks!

[@ultrasoundinstructionvideo7767]

My pleasure!

[@mikedolgopolsky683]

Wow! Thank's a lot. Very useful!

[@ultrasoundinstructionvideo7767]

Спасибо for your kind comment.

[@mikedolgopolsky683]

@@ultrasoundinstructionvideo7767 What about in plane technic? I like placing supraclavicular inplane. Very fast, convinient and safe.

[@ultrasoundinstructionvideo7767]

Unfortunately I can’t say much about in-plane technic as I like out-of-plane technic. Indeed, in-plane technic has distinct advantages as you mentioned. I think that the important thing is to perform a reasonable procedure whichever technique is used. Thank you.

[@mikedolgopolsky683]

@@ultrasoundinstructionvideo7767 Anyway, you are great practioner. Thank you for sharing your experience!

[@mohamedelrazi2880]

Hii ,IAM big fan of your channel and your teaching ,it has been long time no more new podcast.

[@calilyn1026]

no audio???

[@ultrasoundinstructionvideo7767]

Sorry!

[@-omg123]

Why no audio?

[@ultrasoundinstructionvideo7767]

Sorry ... My English is not very good.