A novel technique for ultrasound-guided supraclavicular subclavian cannulation ☆ ☆☆

2010 
Abstract Objective Ultrasound-guided subclavian (SC) access is an inadequately described procedure in the current literature. We recommend using the endocavitary (EC) probe to perform supraclavicular (SUP) SC line placement and evaluate emergency medicine residents' skill and comfort in using this technique after an education session. Methods The EC probe placed in the SUP fossa was used for direct visualization of SUP SC cannulation. Fifteen residents at the University of Utah were educated on this technique. Residents were graded on their ability to visualize the SC vein and answered questions before and after the training. Residents reported their comfort with the technique using a 5-point Likert scale. Results All 15 residents correctly identified the SC vein and rated their understanding of the SUP anatomy before and after the training; average resident comfort rating was 2.9 before training and 4.4 after (95% confidence interval, 1.1-1.9; P Conclusion Ultrasound-guided SUP SC central access using the EC probe may be technically advantageous because of the relatively small probe footprint and fit into the SUP fossa. All participants were able to identify the vein and reported subjective improvement in the understanding of anatomy and comfort with the procedure after a brief training session.
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