EJ is a peripheral vein. Can use it for a PIV or central line in unusual circumstances. Can't recall if the INS standards mention this vein. Pretty sure ACLS training says it's a peripheral.
Can the external jugular vein be used as a central line?
External jugular vein (EJV) may be used as a central line, although it is preferred as a peripheral line since the vein is close to the surface of the skin. While using the external jugular vein for central venous access is associated with minimal complications, it has a relatively high failure rate.
Can a tele nurse D/C an EJ?
As a tele nurse at our facility, we are allowed to d/c IJs and other central lines (with the exception of PICCs), so why would we not be allowed to d/c an EJ? Any thoughts? I've never done it, but it occurs to me that it might depend on your hospital's policy. I'd check with them first.
Are EJ's different to remove than peripherals?
But, yes, I believe they are no different to remove than a peripheral. Specializes in Vascular Access. Has 32 years experience. 1,045 Posts Are floor/tele nurses at your facility allowed to d/c EJs, or does it have to be someone on your IVT team?
What is the best site for a central line placement?
The IJV, the SCV, and the femoral vein are the typical sites for central line placement; each site has its own risks and benefits. Another viable option for access is through the EJV.
What does "big EJ" mean?
How to slow EJ flow?
Can you use a single lumen catheter for femoral art?
Can EJ catheters be positional?
Can a pediatric CVC be placed in the EJ?
Can you put a sterile IJ in a patient's neck?
Do you put in EJ for fistulas?
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About this website
What is an EJ catheter?
External jugular peripherally inserted central catheters (EJ PICCs) are defined as catheters placed through the external jugular vein and advanced into position where the distal tip dwells in the lower one-third of the superior vena cava to the junction of the superior vena cava and the right atrium.
Is a jugular IV a central line?
Central venous catheters provide dependable intravenous access and enable hemodynamic monitoring and blood sampling [1-3]. The jugular veins are one of the most popular sites for central venous access due to accessibility and overall low complication rates. They are the preferred site for temporary hemodialysis access.
Is an EJ considered a peripheral line?
The external jugular vein is considered a peripheral vein and it is consistent with the RN scope of practice as outlined by the Infusion Nursing Society and the Infusion Nurse Standards of Practice, to ensure safe practice and continuity of care for patients.
Is EJ or IJ central line?
EJ is external jugular (peripheral access), IJ is internal jugular (central access). At our facility only ED and ICU nurses place EJ's. Central line indicates that it is arterial access, placed subclavian, jugular, or femoral.
What are the different types of central lines?
Types of central lines include:Peripherally inserted central catheter (PICC). This line is placed in a large vein in the upper arm, or near the bend of the elbow.Subclavian line. This line is placed into the vein that runs behind the collarbone.Internal jugular line. ... Femoral line.
What is an IV line in the neck called?
A temporary central line is a short-term catheter placed in a vein located either in the neck (the internal jugular vein) or less commonly, the groin (the femoral vein). Generally a temporary central line is in place for less than two weeks.
Can a nurse place an EJ IV?
It is the position of the Infusion Nurses Society that a qualified licensed registered nurse, who is proficient in infusion therapy, may insert, care for, maintain, and remove external jugular peripherally inserted central catheters and external jugular peripheral intravenous catheters.
Can you draw blood from an EJ?
Complications: Can I draw blood from an EJ? Yes.
Can nurses place EJS?
EJ placement by nurses is an approved skill by the NC Board of Nursing; evidence-based practice demonstrates a link between patient safety & nurses functioning to the full extent of their training & licensure.
What is an EJ?
Environmental justice (EJ) is the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation and enforcement of environmental laws, regulations and policies.
Is an IJ a PICC line?
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.
What is an IJ catheter?
An anterior approach to the internal jugular vein (IJV) is the best option in this situation because it offers the easiest route with a low risk of complications. In this procedure, a tunneled catheter is surgically inserted into a vein in the neck or chest and passed under the skin.
What is a jugular central line?
A central venous line is a tube that is inserted into one of the large veins leading to the heart. A CVL inserted into the internal jugular vein is used in children who need IV therapy for a long period of time. IV therapy can include medications, chemotherapy and IV fluids.
What is a central line in the neck called?
A central venous catheter, also known as a central line, is a tube that doctors place in a large vein in the neck, chest, groin, or arm to give fluids, blood, or medications or to do medical tests quickly.
Is an IJ a PICC line?
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.
Why do doctors put an IV in your neck?
It makes blood draws easier and allows for the delivery of large amounts of fluid for medication or hydration. It can remain in place for weeks or even months.
What does "big EJ" mean?
FWIW Big EJ often means small IJ. Big EJ also doesn't mean that it will be easier tho thread wire.
How to slow EJ flow?
Hold distal pressure over the EJ with your left middle finger to slow flow into the heart and distend the proximal EJ providing you with a larger lumen to enter.
Can you use a single lumen catheter for femoral art?
We have these long single lumen catheter kits that we use for femoral art lines. Not as long as a TLC, but I might try stuffing that one down the EJ some time
Can EJ catheters be positional?
I have placed many EJ catheters (iv lines in the EJ) but they can be positional. That said, it is a skill worth learning in residency.
Can a pediatric CVC be placed in the EJ?
Another option is to place a pediatric CVC in the EJ. They are less likely to work themselves out of the vein and go sub q .
Can you put a sterile IJ in a patient's neck?
I agree with all of the concerns above. However, they are sometimes extremely easy to place and can get you out of trouble if the neck is not easily accessible to do a sterile IJ (as Doze mentioned). They can be lightning quick to put in if the patient isnt to adipose heavy...liberating you to take care of other (pressing) tasks. Some patients have bulging EJs. Just depends on the patient, IMO.
Do you put in EJ for fistulas?
I do alot of vascular patients, many of whom have had fistulas on both extremities. I don't want to go through the drama of a central line for a small case , so I will put in an EJ if they have a good looking one. I make sure to aspirate back every so often to confirm that its in the vein.
Where is the EJV lateral to the SCM?
As the EJV nears the clavicle, just lateral to the insertion of the lateral head of the SCM, it pierces the deep fascia and receives other tributaries just prior to emptying into the SCV lateral to the termination of the IJV.
Where is the EJV located?
The EJV is formed primarily by the confluence of the retromandibular and posterior auricular veins near the angle of the mandible (see the first image below). It remains superficial in the neck and is loosely fixed in the subcutaneous tissues, traversing the sternocleidomastoid (SCM) obliquely just deep to the platysma (see the second image below).
Why is it so difficult to catheterize an EJV?
Also, the presence of an acute angle between the EJV and the SCV, the presence of valves, and constriction of the EJV as it penetrates the fascial layers can contribute to a difficult catheterization. Because the EJV is superficial to the IJV and the carotid artery, it is important to make sure that the skin is entered at a shallow angle (~10-25°).
How many bicuspid valves are there in an EJV?
The EJV generally has two bicuspid valves, one at the junction with the SCV and the other approximately 4 cm upstream. [ 16, 2] In about 4% of patients, the terminal end is a venous plexus instead of a single channel. [ 2] .
What is the success rate of EJV?
[ 6] In subsequent studies, technical success rates ranged from 73% to 88%. [ 22] Advantages to using the EJV for central venous access include its superficial position and its distance from vital structures, which decrease the risk of major complications such as pneumothorax.
What is entrapment between wire and needle?
Vein-wall entrapment between wire and needle, most likely associated with the in-out wire maneuver frequently required for wire passage beyond the valves. Catheter malfunction from kinking that can occur as a result of the circuitous route to the central circulation.
Is EJV the same as central venous access?
The indications for external jugular vein (EJV) central venous access are generally the same as those for all other routes. Although the list below is all-inclusive, not all of these indications are considered prudent or possible in each individual patient (eg, a dialysis catheter may be too large for the caliber of the vessel in some patients).
What does "big EJ" mean?
FWIW Big EJ often means small IJ. Big EJ also doesn't mean that it will be easier tho thread wire.
How to slow EJ flow?
Hold distal pressure over the EJ with your left middle finger to slow flow into the heart and distend the proximal EJ providing you with a larger lumen to enter.
Can you use a single lumen catheter for femoral art?
We have these long single lumen catheter kits that we use for femoral art lines. Not as long as a TLC, but I might try stuffing that one down the EJ some time
Can EJ catheters be positional?
I have placed many EJ catheters (iv lines in the EJ) but they can be positional. That said, it is a skill worth learning in residency.
Can a pediatric CVC be placed in the EJ?
Another option is to place a pediatric CVC in the EJ. They are less likely to work themselves out of the vein and go sub q .
Can you put a sterile IJ in a patient's neck?
I agree with all of the concerns above. However, they are sometimes extremely easy to place and can get you out of trouble if the neck is not easily accessible to do a sterile IJ (as Doze mentioned). They can be lightning quick to put in if the patient isnt to adipose heavy...liberating you to take care of other (pressing) tasks. Some patients have bulging EJs. Just depends on the patient, IMO.
Do you put in EJ for fistulas?
I do alot of vascular patients, many of whom have had fistulas on both extremities. I don't want to go through the drama of a central line for a small case , so I will put in an EJ if they have a good looking one. I make sure to aspirate back every so often to confirm that its in the vein.
