Trick of the Trade:
Ultrasound-guided supraclavicular approach to subclavian line
What are the surface anatomy landmarks for the supraclavicular line?
- Identify the border of the clavicle and lateral margin of the clavicular belly of the sternocleidomastoid muscle.
- Insert the needle there and aim for the contralateral nipple, aiming anteriorly 10-20 degrees to avoid puncturing the subclavian artery and lung.
- You are trying to cannulate the near the juncture of the IJ and subclavian veins.
If you just want to see the crux of the procedure, which uses the linear transducer to guide the long-axis needle insertion approach, start at 8:18.
Disclaimer: I do not have any commercial affiliations with Sonosite.
Patrick SP, Tijunelis MA, Johnson S, Herbert ME. Supraclavicular subclavian vein catheterization: the forgotten central line. West J Emerg Med. 2009 May;10(2):110-4. Free access to PDF