THE ROLE OF SONOGRAPHY IN THE PLACEMENT AND MANAGEMENT OF JUGULAR ANDSUBCLAVIAN CENTRAL VENOUS CATHETERS

Placement of large-bore central Venous catheters via a jugular or subc lavian vein is becoming increasingly common. Although the great majori ty of these catheters are successfully placed by clinicians using anat omic landmark techniques, this procedure is neither innocuous nor alwa ys successful. Serious complications, including hematomas, arterial in jury, and pneumothorax can occur. The patient may experience considera ble discomfort when multiple needle passes are made. Sonographic imagi ng of the jugular and subclavian veins can significantly improve the s afety, speed, and comfort of the procedure by defining the vascular an atomy of the jugular and subclavian veins before puncture, showing com plications from prior attempts or placements of central venous cathete rs in these vessels, and providing guidance for needle puncture of the jugular and subclavian veins.