How to Insert a Jugular Vein Cannula
Inserting a Juglar Vein Cannula is a serious medical procedure and should be treated as such. In pre-hospital care, as paramedics, IV insertion in the Jugular vein should be reserved to near-death situations and cardiac arrests.
This is because of the considerable risks associated with cannulating the jugular vein, not to mention the discomfort to the patient.
To insert a Jugular Vein IVC:
Explain to the patient what is going to happen (although they should probably be unconscious before you even think about attempting this in pre-hospital care);
Place the patient supine (and ideally with their legs elevated to increase the venous pooling and engorgement of the jugular vein).
Turn the patient’s neck away from the cannulation side;
Swab the site with an alcohol wipe. This is particularly important when inserting an IVC into a jugular vein due to the increase risk of systemic infection due to the size of the vein.
Prepare cannulation equipment;
Choose a cannula site. This will often being midway between the angle of the jaw and clavicle, lateral of the thyroid notch (but, at the end of the day, anywhere you can see a massive vein that you believe you can insert a large bore cannula will do just fine).
Tension the vein (this is very important in this size vein;
Insert the cannula at an angle of 15-30 degrees and with the bevel of the needle pointing upwards.
When a large flashback is observed, lower the cannula and advance the needle into the vein.
Occlude the vein proximally and remove the cannula needle before inserting the valve to the cannula;
Inject 10 mls of saline or hartmanns to ensure that the IV cannula is patent (although it’s pretty hard to miss the largest vein in the body).
Don’t forget neck is like any other limb, so you have to insert the cannula head downwards to ensure it maintains the normal flow of the venous blood. See picture (coming soon).