Small IJ

[caligas]

Neck lines for heart. US of Right IJ shows a vessel a bit smaller than carotid. Left side is huge. Which side do you go for?

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[urge]

Right side. As long as you can cannulate it, it should work fine.

 

[DM27]

If there isn't a concern that the right side is for some reason occluded, it wouldn't stop me from cannulating it.

 

[urge]

If there isn't a concern that the right side is for some reason occluded, it wouldn't stop me from cannulating it.

If it were obstructed the vein would be enlarged, not small.

 

[DM27]

If it were obstructed the vein would be enlarged, not small.

It completely depends on where the obstruction is and the chronicity of it. If there is a chronic clot and little to no flow the vein will eventually become atretic. It can also becoming smaller from luminal thickening due to chronic non occlusive clot.

An obstruction at or close to its emptying point and an unchanged vein structure and flow would result in a larger vein.

Regardless, my point was not a small vein is a concern for obstruction of some kind. It was simply if the vein is small but has flow and does not appear to have an obstruction in it then I would cannulate as usual.

 

[anesthesiadoc]

advance the catheter until you get to the wide part/ RA

 

[nimbus]

If you don’t use ultrasound and just go by landmarks like the manly men advocate, this thread is moot