Pearl of the Day: Easy IJ

Easy Internal Jugular (IJ)

- placement of single-lumen catheter into IJ using ultrasound guidance

- in a prospective study by Moayedi et al. 2016, 83 attempts recorded in 74 patients with initial success rate 88% and mean procedure time 4.4 min; complications included loss of patency in 14% (95% CI 7 - 24%), and 0/83 with pneumothorax, line infection, arterial puncture


- patients who do not require triple lumen catheter but with difficulty in obtaining peripheral access


- ultrasound with linear probe

- chlorhexidine

- 18-gauge catheter at least 2 inches long

- sterile probe cover

- sterile lubricant

- sterile gloves


- similar to ultrasound-guided peripheral IV placement

- increased success may be achieved with Trendelenburg position and Valsalva maneuver with head turned toward opposite side of target vein

- does not require full sterile drape or gown

Post-procedure Recommendations

- may check CXR to r/o pneumothorax

- intended for 24 hour use, but may be left in longer, up to 7 days in some studies


Butterfield M et al. Using Ultrasound-Guided Peripheral Catheterization of the Internal Jugular Vein in Patients with Difficult Peripheral Access. Am J Ther 2015. PMID 26469683

Moayedi S et al. Safety and efficacy of the “easy internal jugular (IJ)”: an approach to difficult intravenous access. J Emerg Med. 2016; 51(6): 636-642. PMID 27658558