hello I'm Brian Johnson I'm an Emergency Physician and today we're going to use the clarius pal probe to look at the internal jugular vein for a central line access we're not going to perform a central line today what we're going to do is identify the sonographic landmarks for a central line and so you have the patient Supine and the head rotated laterally typically we'll be doing a right IJ but you can certainly do left IJ as well so you're going to take your probe and place it on the side of the neck like so and what you'll immediately see is the sternocleanomastoid on top and you'll see this large triangular structure that's seems to be variating with respiration and that's the internal jugular vein when I compress down you see that the internal jugular vein compresses as well and that proves it's a vein in the internal jugular vein what you want to stay away from or also identify is the Carotid artery the credit artery that's deeper and more medial it also has a thicker walled membrane and when you put color flow you see that it's pulsatile and that's the Carotid artery go back to 2D ultrasound can help with accuracy of identifying the internal jugular vein and help minimize complications thank you
