It is easy. Once you see how the machine works, you would never want to go back to the "blind poking". Even if you do not use the machine for the actual placement, it is encouraging to check before the procedure that the vein is there, big and ready for the needle. I still remember 2 patients - one of them did not have a patent right IJ vein. The other patient had AIDS with a viral load of 90,000, he was with PCP and on a vent. Every time he took a breath, the IJ vein collapsed. Even if you get in the vein, you cannot thread in the wire. In both cases the ultrasound helped.
We use the SiteRite ultrasound machine.
It is definitely proven that ultrasound- guided central line placement is more effective and safe than the" blind" placement.
You can check the educational brochures about the ultrasound TLC placement at the manufacturer's website.
Image source: SiteRite
References:
Procedure Skills and ACLS Refresher
Ultrasound-Guided Central Venous Cannulation. Society of Cardiovascular Anesthesiologists.
Internal Jugular Vein Cannulation - The UCSF Hospitalist Handbook
Central Venous Access. eMedicine, July 29, 2005.
VenousAccess.com Slides
Central Line Placement. Blueprints Clinical Procedures by Laurie L Marbas, Erin Case. Blackwell Publishing, access via Google Book Search.
Further reading:
Invasive procedures - BMJ 12/05
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