A 48-year-old man on ICU requires emergency central venous catheter insertion. The team uses ultrasound to guide right internal jugular vein (IJV) can...

Question

A 48-year-old man on ICU requires emergency central venous catheter insertion. The team uses ultrasound to guide right internal jugular vein (IJV) cannulation. During the pre-procedural scan, they note the IJV is thrombosed (echogenic material within the vessel, non-compressible). What is the most appropriate next step?

Accepted Answer

Select an alternative site - left IJV, subclavian, or femoral - and document the incidental thrombosis for anticoagulation consideration

Answer

Proceed with right IJV cannulation through the thrombus

Answer

Abandon the procedure entirely

Answer

Use a landmark technique on the same side

Answer

The ultrasound finding is always artefactual

uk-fficm MCQ (SBA): CVC - Pre-Procedural USS Finding