Internal Jugular Central Lines

Small Bore Internal Jugular Central Lines provide benefits to those patients with limited access to the chest or arm area. This page describes situations in which an Internal Jugular Central Venous Catheter Line should be considered to avoid potential complications such as those in patients with breast cancer, risk of lymphedema, deep vein thrombosis (DVT), chronic kidney disease, upper arm cellulitis, or any who are contraindicated for other lines.

VASCULAR ACCESS SPECIALISTS

As Vascular Access Specialists, Vascular Wellness nurse clinicians are Vascular Access Board Certified (VA-BC), insured, skill-verified, and salaried W2 employees.  Vascular Wellness requires bi-annual skill verification ensuring adherence to proprietary policies, procedures, competencies, and best practices.  We focus on holistic and comprehensive care and do not follow the pay per procedure model plus performance bonuses used by others that may create some adverse incentives for speed at the bedside versus holistic medical care helping to ensure the placement of the right line at the right time, the first time.  In fact, Vascular Wellness employs a Director of Research and Development who not only helps us stay up to date on best practices but helps us continue to innovate and improve upon Vascular Access Services.

Vascular Access Specialists from Vascular Wellness

Vascular Access Specialists practice holistic medical care, meaning talking to the patient, addressing questions and fears, and performing a comprehensive medical review.  Prior to delivering any Vascular Access procedure, the Vascular Wellness clinician reviews the patient’s medical record, including history and lab reports, and independently verifies and confirms the doctor’s order.  If our clinician has questions or disagrees with the prescribing doctor, the clinician will consult with the doctor. Our Vascular Access Specialists have earned the trust of many doctors, and such doctors will defer to the clinician’s recommendation by ordering a “consult” as compared to a specific line.  Patient safety and vein preservation are critical – which is why a holistic, comprehensive evaluation and Advanced Lines are significant.  Other companies claiming to be Vascular Access Specialists may not follow this same approach frustrating medical doctors and nurses primarily because those 1099 Contractor PICC nurses do not place Advanced Lines (i.e, no options other than PIVs, Midlines, and PICCs) and get paid on a pay per procedure model.

In states where nurses are permitted, as Vascular Access Specialists, Vascular Wellness clinicians can provide immediate X-Ray Clearance of lines when tip confirmation is not available or appropriate and X-Ray confirmation must be used. This saves money, time, and coordination with a Radiologist or other doctor and enables the lines to be used immediately to avoid delaying treatment. Quicker therapy leads to better outcomes.

As Vascular Access Specialists, Vascular Wellness uses top rated and hospital preferred supplies from Becton Dickinson, formerly Bard (BD). Superior supplies and services help mitigate the potential for poor outcomes such as bad placement, clotting, infections, and other adverse events.  Other companies that are not Vascular Access Specialists may opt for inferior supplies and older equipment.

Internal Jugular Central Lines

Internal Jugular Central Lines are excellent alternatives when other central lines such as Peripherally Inserted Central Catheter (PICC) Lines and Small Bore Axillary or Femoral Central Venous Catheter Lines are unavailable or contraindicated. There are many reasons why such lines can be contraindicated and an Internal Jugular Central Line will provide the access needed to reach the large vein above the heart, the superior vena cava (SVC).

Small Bore Internal Jugular Central Venous Line

Internal Jugular Central Lines Illustration

Internal Jugular Central Lines

– Use Cases

Use Cases for Internal Jugular Central Lines include:

(a) when an Axillary Central Venous Line is unavailable.

(b) when a patient has had a bilateral mastectomy with lymph node removal, usually in the case of breast cancer, and has a high risk of lymphedema. Lymph node removal results in less lymph nodes to filter the lymph, a clear fluid that filters waste throughout the tissues in the body. The waste builds up and can lead to lymphedema, an upper extremity swelling that will be permanent. A Small Bore Axillary Central Venous Line is not an option as it is too close to the chest, upper arm and arm pit area which is near the mastectomy site.

(c ) when a patient is contracted such that their muscles in their body have shortened and their arms will not extend out from the side of their body.

(d) when a patient presents with chronic kidney disease such that labs results show creatinine is equal to 2 or greater or GFR is below approximately 45, which indicates stage 3 Chronic Kidney Disease. Vascular Wellness follows Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines for line placement. The Internal Jugular line maintains upper arm vein preservation as permanent dialysis utilizes upper arm veins for Arteriovenous fistula (AV) graft and also doesn’t disturb any current AV Fistula.

(e) when a patient presents with bacterial cellulitis. Bacterial cellulitis is an infection of the skin that causes swelling, redness and pain.

(f) when a patient is diagnosed with a deep vein thrombosis (DVT) or a DVT within three months of line placement. An Upper Extremity Deep Vein Thrombosis (UEDVT) is defined by a DVT (blood clot) in the peripheral veins of the arms. PICCs and Midlines can cause UEDVTs.

Internal Jugular Central Lines

– Vascular Wellness

When clinically indicated, Vascular Wellness clinicians will insert an Internal Jugular Line into the vein and weave it to the SVC. This is a central line that is not peripherally inserted, such as a PICC line.

Vascular Wellness clinicians have the ability to place and choose many of the more complex lines. An Internal Jugular Line is considered an advanced central line that requires additional training, not usually found in most vascular access nurse departments or outsource providers.

With our experience and skills, Vascular Wellness has and continues to place small bore central venous catheter lines at similar very high success rates and zero insertion related infections as we do with PICCs. Vascular Wellness is a comprehensive Vascular Access Solution with the tools and training to provide the right Vascular Access at the Right Time, the First Time.

For more about our Small Bore Central Venous Catheters read the article HERE…

Small Bore Internal Jugular Central Venous Catheter Lines

Internal Jugular Catheter is a central line that is not peripherally inserted, such as a PICC line

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Vascular Wellnesssm provides clinical vascular access nursing services at the bedside across the Southeast to a diverse client base including Tertiary Hospitals, Community Hospitals, Long Term Acute Care Hospitals, Skilled Nursing Facilities, Surgical and Outpatient Centers,  Hospice, and At-Home care.

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Cary, NC 27519
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