Central Lines

Finding a Vein



  • Internal jugular vein - identify the vein using ultrasound. Place the probe between the two heads of the sternocleidomastoid and look for a large-bore, non-pulsating, collapsible vessel lateral to the carotid artery.
  • Subclavian - identify the vein using landmarks. Identify the junction of the medial third and lateral two-thirds of the clavicle. The needle should be inserted 1cm inferior and lateral to this, pointing toward the sternal notch, upward and away from the underlying lung apex.
  • Femoral - identify the vein using ultrasound. Place the probe in the groin over the femoral triangle, below the inguinal ligament. Look for a large-bore, non-pulsating, collapsible vessel medial to the femoral artery.
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Baik SY, Kim EK, Hong SK. Strategies to prevent central line-associated bloodstream infections in intensive care units. Journal of Microbiology, Immunology and Infection. 2015 Apr 1;48(2):S75-6.
 Bannon MP, Heller SF, Rivera M. Anatomic considerations for central venous cannulation. Risk Manag Healthc Policy. 2011;4:27-39. Czepizak CA, O’Callaghan JM, Venus B. Evaluation of formulas for optimal positioning of central venous catheters. Chest. 1995 Jun 30;107(6):1662-4.
Graham AS, Ozment C, Tegtmeyer K, Lai S, Braner DA. Central venous catheterization. N Engl J Med. 2007 May 24;356(21):e21.
 Vesely TM. Central venous catheter tip position: a continuing controversy. Journal of Vascular and Interventional Radiology. 2003 May 31;14(5):527-34.