Catheterization of the subclavian vein through the cannulation of the external jugular vein. Our experience

UNLABELLED: The cannulation technique of the subclavian vein by the external jugular vein is described. OBJECTIVE: To point out this simple and safe method without complications deriving from the direct needle-prick of the subclavian vein. METHODS: Experimental plan. The comparative study includes 30 patients in the resuscitation department during the second half-year in 1996. Place. Resuscitation Department of the University Polyclinic in Palermo. Patients. 30% of these patients were male and 70% were female; coagulative serious disorders were present in some patients, in others the coagulative picture was unknown. Interventions and observations. The modified Seldinger technique has ben used, introducing a J wire through the needle cannula put in the external jugular vein, taking care not to exceed the length of the latter with the J wire. Less rigid and small catheters have been used which can fluctuate in the running blood and be carried in the superior vein cava. Once the subclavian vein has been cannulated, a Rx graph control of the thorax was made, showing the excellent position of the catheter. RESULTS: Only one failure, but this technique has not showed complications. CONCLUSIONS: This technique finds applications in all situations of extreme emergency, in which on the one hand it needs a central blood vessel, on the other there are hemorrhagic problems or there isn't any possibility to do a coagulative screening in short time.