Internal Jugular Line Course

Central line placement is indicated in patients who need hemodynamic monitoring, rapid volume resuscitation, therapies such as vasopressors and hypertonic saline and in patients with difficult venous access.  The central line placement course will teach clinicians how to place central venous catheters in the subclavian, internal jugular and femoral veins using advanced simulation manikins.  The course covers central venous access indications, contraindications, preparation, technique, complications and their management.  Techniques for triple lumen, cordis and hemodialysis catheters will be taught.  The course will cover both landmark-based central line placement and ultrasound-guided central line insertion.

Our internal jugular line placement training is a component of our live Hospitalist and Emergency Procedures CME course which teaches clinicians how to perform the 20 most essential procedures needed to work in the ER, ICU, and hospital wards.

CLICK HERE to find out more about our premier live Hospitalist and Emergency Procedures CME course

Internal Jugular Line Course

Internal Jugular Line Placement Lab Photos

Internal Jugular Line Video

Internal Jugular Line Video


Internal Jugular Line Placement Course trains students in:


  • Indications for a internal jugular venous catheter placement
  • Contraindications for internal jugular venous catheter placement
  • Complications of a internal jugular venous catheter placement
  • Equipment for internal jugular venous catheter placement
  • Proper positioning and technique for internal jugular venous catheter placement
  • Internal jugular venous catheter troubleshooting
  • Coding for internal jugular venous catheter placement

Internal Jugular Line Placement Photos

Central Line Reference Card

Central Line Reference Card

Central Line Reference Card

More information about Internal Jugular Line Placement

An internal jugular line placement may need to be performed for a variety of medical conditions, or emergency procedures.  This can be a technically challenging procedure and in some cases the patient may be very ill or significantly injured.

Due to the jugular vein's position adjacent to the carotid artery and several adjacent muscles, the internal jugular line placement must be performed with careful precision.  Complications arising from the procedure can result in carotid artery damage, haematoma, and pneumothorax in some rare cases, death.  As a result of the potential for serious damage to surrounding arteries and muscles, ultrasound is often used to assist in the placement of the internal jugular line.

Ultrasound vs. Landmark-based

In general, ultrasound guidance is preferred over the landmark-based technique.  Ultrasound guidance has increased internal jugular line placement success rates to over 90%.    Compilications arising from the procedure decreased by 57% when using ultrasound to locate the jugular vein as opposed to the landmark-based technique.  The most obvious reasons for the preference for ultrasound assisted IJ line placement included a higher success rate overall, higher first attempt success, shorter access time, lower chance of carotid artery puncture, and lower chance of hematoma.

Using the ultrasound based technique, imaging provides the hospitalist or emergency physician with the location of the jugular vein.  The landmark-based technique involves a physician or other qualified personnel determining the location of the jugular and best entry position according to its position relative to adjacent muscles, tissue, and arteries.

Why Internal Jugular Line Placement?

Internal placement has several proven benefits when compared to the peripheral IV placement.  The internal jugular approach is preferred when possible due to the vein's significant rate of blood flow,  substantial size, relatively straight orientation, and small mal position rate.  The most obvious drawback to the internal jugular vein is its location near the carotid artery.  The internal jugular vein is the most typical choice for central access by anesthesiologists.

Don't see what you're looking for - Ask the Experts!

Internal jugular line placement has numerous applications for a variety of medical procedures.  If you have a question that isn't answered on this page, or if you're just interested in discussing the procedure in greater detail, then we encourage you to contact an HPC physician directly at  It is our goal to provide an expert online resource for your hospital procedures and emergency medicine queries.  We look forward to discussing!

Internal Jugular Line Placement Blogs

In plane ultrasound-guided central line placement is preferred over out-of-plane technique

by Joseph Esherick, M.D., FAAFP, FHM

A study from an urban EM residency program determined that in-plane ultrasound-guided central venous catheterization is superior to out-of-plane ultrasound-guided central line placement.

Which cirrhotic patients are at high risk for bleeding during hospital procedures?

by Joseph Esherick, M.D., FAAFP, FHM

The standard tests to assess bleed risk do not accurately predict bleed risk in cirrhotic patients during bedside procedures.

Ultrasound-guided Central Venous Access: Are Landmarks a Thing of the Past?

by Rick Rutherford, M.D., FAAFP

Ultrasound has improved the safety and efficiency of a wide range of procedures including ultrasound-guided central line insertion

Simulation Based Training for Central Venous Catheters

by Rick Rutherford, M.D., FAAFP

Balancing patient safety with trainee experience presents an ongoing challenge in medicine. Simulation based training has been proposed as a tool to improve the safety of bedside procedures, but has not been rigorously studied. This metaanalysis reviews the evidence available and evaluates whether simulation based training improves success rates for central venous catheter placement.

Hospitalist and Emergency Procedures CME Courses Available

Register HERE 21 days before the course to SAVE $50-150 and get the following:

  1. 12 month online access to Online CME course, procedure video bundle, instructional posters
  2. Indefinite online access to PDFs of all course lectures, course handouts, and HPC Adult Critical Care and Emergency Drug Reference Drug