An assessment of an alternative method of internal jugular vein catheterisation.

This study assessed a tried, but previously unpublished, method of internal jugular vein cannulation in 50 patients scheduled for elective cardiac surgery. The method involves using two landmarks: the larynx (thyroid and cricoid cartilages) together with the carotid artery (if it is palpable). The cricoid and thyroid cartilages were readily identifiable in 48 (96%) patients. The carotid artery was palpable in 45 (90%) patients, although some difficulty in palpation was recorded in 24 (48%) patients. There was a 98% success rate of venous cannulation. In 90% of cases the 21 gauge seeker needle entered the vein on the first or second attempt, and in 82% of cases the subsequent 18 gauge introducing needle entered the vein on the first attempt.