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KEY IMAGES

Transverse view of neck vein and artery

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Video 11-01: Transverse view of carotid and internal jugular

The anatomy of the right neck is visible in this clip acquired in the transverse view. The carotid can be seen medial, and has pulsatile flow. The heterogenous structure to the left of the carotid is the thyroid gland. The sternocleidomastoid muscle overlies both the carotid and internal jugular vein. The color of the flow does not indicate the oxygenation status of the blood, instead merely demonstrates whether blood is moving toward or away from the transducer, but in this case the carotid artery is red and the jugular vein is blue.

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Hand position, transverse

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Video 11-02: Transverse view of carotid and internal jugular

This video demonstrates an ideal patient setup and how to apply gel to the probe and to apply a sterile probe cover. 1 min, 41 secs 640 360

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Longitudinal view of vein with catheter

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Video 11-03: Longitudinal view of the catheter in the vein

In the longitudinal axis a post procedural ultrasound can visualize the catheter and ensure that it remains within the internal jugular vein without penetrating the posterior wall.

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Hand position, longitudinal

Transverse view of needle entering vessel

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Video 11-04: Needle accessing the internal jugular vein in the transverse view

When the needle is about the enter the vein there will frequently be indentation of the superficial side of the vessel. Caution is required at this point, as too much pressure will result in a sudden release of that tension and the needle penetrating the posterior wall. In this case, once the vessel wall releases and the vein returns to a round shape the needle can be seen near (but not through) the posterior wall of the internal jugular vein.

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Longitudinal view of needle in vessel

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Video 11-05: Needle accessing a vessel in longitudinal axis

In the longitudinal view the needle and the bevel can be visualized throughout the pass into the vessel.

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Longitudinal view of wire in vessel

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Video 11-06: Wire entering the vessel in longitudinal view

Once in the vessel, the wire can be advanced. In the longitudinal view a confirmatory examination with ultrasound should show a gently curved wire lying against the posterior side of the vessel, not passing through the posterior wall.

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