(Last Updated - 5/6/2007)
-Infraclavicular Medial Approach:
-The needle is inserted ~1 cm inferior to the junction of the proximal 1/3 and distal 2/3 of the clavicle
-Direct the needle toward the suprasternal notch at a 10-15 degree angle with the skin
-Angle of needle entry should be no more than 15 degrees to avoid lung puncture and pneumothorax
-Infraclavicular Lateral Approach:
-The needle is inserted ~1 cm inferior to the junction of the proximal 2/3 and distal 1/3 of the clavicle
-Direct the needle toward the suprasternal notch at a 15 degree angle with the skin
-Unintentional IJ placement is less common with this approach
-Risks of subclavian artery puncture and brachial plexus injury are increased
-Supraclavicular Approach:
-The needle is inserted cephalad to the clavicle and lateral to the junction of the clavicular head of the sternocleidomastoid muscle and the clavicle
-Least commonly performed of the options
========================================================
References:
1) Up-To-Date 2007.