Is external jugular vein cannulation feasible in emergency care? A randomised study in open heart surgery patients.
The optimal intravenous catheterisation site for emergencies is unknown. The external jugular vein might be preferable route compared to cubital veins in emergencies due to more rapid circulation time to heart and faster cardiac responses. However, the feasibility of the different venous catheterisation sites has not been compared in relation to catheterisation time and success rate.


METHODS
We examined the time differences and success rates of external jugular compared to antecubital vein catheterisations. 32 paramedics and 28 emergency department residents performed external jugular and antecubital venous catheterisations on anesthetized patients scheduled for elective cardiac surgery. The primary outcome was catheterisation time and the secondary outcomes the failure rate and catheterisation times needed to succeed.


RESULTS
Antecubital venous catheterisation was faster (113+/-89s) compared to external jugular vein catheterisation (156+/-112s), p=0.008 and the success rate was higher (93% compared to 68%, respectively, p=0.001). Less attempts were needed for antecubital vein catheterisations compared to external jugular vein catheterisations (p=0.002). For the antecubital vein, subjects needed two attempts in 6 patients and three attempts in 6 patients. For the external jugular vein, subjects needed two attempts in 13 patients and three attempts in 20 patients. Two (6%) paramedics and two (7%) residents failed to catheterise the antecubital vein. Nine (28%) paramedics and 10 (36%) residents failed to catheterise the external jugular vein.


CONCLUSIONS
Antecubital vein catheterisation was faster and had a superior success rate compared to external jugular vein catheterisation.
Lahtinen
Pasi
P
Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland. pasi.lahtinen@kuh.fi
Musialowicz
Tadeusz
T
Hyppölä
Harri
H
Kiviniemi
Vesa
V
Kurola
Jouni
J
D001132:Arm / Q000098:blood supply; D002405:Catheterization, Central Venous / Q000379:methods*; D016009:Chi-Square Distribution; D004632:Emergency Medical Services; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000601:surgery*; D006801:Humans; D007601:Jugular Veins; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome