Central line placement is indicated in patients who need hemodynamic monitoring, rapid volume resuscitation, therapies such as vasopressors and vesicant or central parenteral nutrition infusions and in patients with difficult venous access.
The central line placement course will teach clinicians how to place central venous catheters (subclavian line placement, internal jugular line placement and femoral line placement) using advanced simulation manikins. The course covers central venous access indications, contraindications, preparation, technique, complications and their management. Techniques for triple lumen, cordis and hemodialysis catheters will be taught. The course will cover both landmark-based central line placement and ultrasound-guided central line insertion. The course emphasizes ultrasound-guided vascular access.
The HPC Hospitalist and Emergency Procedures course will teach you how to perform central line placement in addition to endotracheal intubation, stylet-guided intubations, laryngeal mask airway (LMA) placement, King tube placement, or fiberoptic intubations. ultrasound-guided peripheral IV access, arterial lines, POCUS exams (RUSH exams and E-FAST exams), thoracentesis, paracentesis, lumbar punctures, chest tube placement, pigtail catheter placement, needle thoracostomy, procedural sedation, and ventilator management.
Our central line placement training is a component of our live Hospitalist and Emergency Procedures CME course which teaches clinicians how to perform the 20 most essential procedures needed to work in the ER, ICU, and hospital wards.
Take your skills to the next level with our comprehensive Internal Jugular Line Course!
An internal jugular line placement may need to be performed for a variety of medical conditions, or emergency procedures. This can be a technically challenging procedure and in some cases the patient may be very ill or significantly injured.
Due to the jugular vein’s position adjacent to the carotid artery and several adjacent muscles, the internal jugular line placement must be performed with careful precision. Complications arising from the procedure can result in carotid artery damage, haematoma, and pneumothorax in some rare cases, death. As a result of the potential for serious damage to surrounding arteries and muscles, ultrasound is often used to assist in the placement of the internal jugular line.
In general, ultrasound guidance is preferred over the landmark-based technique. Ultrasound guidance has increased internal jugular line placement success rates to over 90%. Compilications arising from the procedure decreased by 57% when using ultrasound to locate the jugular vein as opposed to the landmark-based technique. The most obvious reasons for the preference for ultrasound assisted IJ line placement included a higher success rate overall, higher first attempt success, shorter access time, lower chance of carotid artery puncture, and lower chance of hematoma.
Using the ultrasound based technique, imaging provides the hospitalist or emergency physician with the location of the jugular vein. The landmark-based technique involves a physician or other qualified personnel determining the location of the jugular and best entry position according to its position relative to adjacent muscles, tissue, and arteries.
Internal placement has several proven benefits when compared to the peripheral IV placement. The internal jugular approach is preferred when possible due to the vein’s significant rate of blood flow, substantial size, relatively straight orientation, and small mal position rate. The most obvious drawback to the internal jugular vein is its location near the carotid artery. The internal jugular vein is the most typical choice for central access by anesthesiologists.
Internal jugular line placement has numerous applications for a variety of medical procedures. If you have a question that isn’t answered on this page, or if you’re just interested in discussing the procedure in greater detail, then we encourage you to contact an HPC physician directly at www.Facebook.com/HospitalProcedures. It is our goal to provide an expert online resource for your hospital procedures and emergency medicine queries. We look forward to discussing!
Meet Our Expert Instructors
Joseph Esherick, M.D., FAAFP, FHM is the Director of Medicine, a hospitalist and ICU physician at the Ventura County Medical Center in Ventura, California. He is also an Associate Clinical Professor of Family Medicine at The David Geffen School of Medicine at UCLA.
Dr. Rutherford graduated with honors from the University of Washington School of Medicine in 2001 and went to Ventura County Medical Center in California for his Family Practice internship and residency. He also served as Medical Director of Quality for Ventura County Medical Center and St. Paula Hospital.
Dr. Speier earned his medical degree from University of California at Irvine School of Medicine with AOA honors and completed his family medicine residency at Ventura County Medical Center in Ventura, California.
Dr. Leu earned his medical degree from Eastern Virginia Medical School in Norfolk, Virginia, completed his residency in Emergency Medicine at Cook County Hospital in Chicago, IL
Real Success Stories: Discover What Our Participants Say!
“The most educational course for procedures! Manikins are the best. Instructors are dedicated to us learning.” – Denise Clay, M.D., Florida
“Comprehensive. Very well organized. Taught by clinicians with lots of experience. Excellent course for any hospitalist who is seeking to learn, re-learn, or fine tune their procedural skills!!” – Jack Artinian, M.D., Michigan
“What a great course this is! You have every reason to be proud of this accomplishment. The learning environment you created really works!” -Ati Yates, Eugene, OR
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These lectures include clinical pearls and common pitfalls associated with bedside procedures, how to avoid complications and how to manage complications related to bedside procedures should they occur.
These lectures include clinical pearls and common pitfalls associated with ventilator management, how to avoid complications and how to manage complications related to NIV and mechanical ventilation should they occur.
The Vascular Access Course provides information about venous anatomy, and provides step-by-step instruction including high-quality videos about landmark-guided and ultrasound-guided central line placement, intraosseous line (IO line) placement, ultrasound-guided peripheral IV insertions and ultrasound-guided arterial line placement.
The course also covers the medications used and step-by-step protocol for performing awake intubations, rapid sequence intubations, and delayed sequence intubations.
The Point-of-Care Ultrasound (POCUS) Course On-Demand provides an introduction to ultrasound knobology and probes and provides clinical pearls about how to optimize your sonographic image on the ultrasound monitor.
The informed consent lecture covers the consent of both adults and minors, and the challenges of informed consent including the consent of incapacitated and/or unbefriended patients.
