Landmarks

Various landmarks have been described. For example:

• Internal jugular: Halfway between mastoid process and sternal notch, lateral to carotid pulsation and medial to medial border of sternocleidomastoid. Aim toward ipsilateral nipple, advancing under body of sternocleidomastoid until vein entered.

• Subclavian: 3 cm below junction of lateral third and medial two thirds of clavicle. Turn head to contralateral side. Aim for point between jaw and contralateral shoulder tip. Advance needle subcutaneously to hit clavicle. Scrape needle under clavicle and advance further until vein entered.

• Femoral: Locate femoral artery in groin. Insert needle 3cm medially and angled rostrally. Advance until vein entered.

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