Content area
Full text
For safe and successful subclavian vein cannulation via the infraclavicular route, the skin is punctured 2 to 3 cm caudal to the midpoint of the clavicle and thereafter it is advanced in an upward and inward direction towards the suprasternal notch. At times it is difficult to maintain the desired angulation of the needle when a syringe is attached to its proximal end, paticularly in patients who are either obese, of short stature or females with prominent breasts. In these situations, the syringe end of the assembly must be lifted up, increasing the angulation and thereby increasing the chances of complications such as pneumothorax and arterial puncture. In order to achieve the desired angulation, we suggest connecting a flexible extension tube (5 cm) between the introducer needle and syringe. Due to the flexible nature of the extension tube, this facilitates attainment of the desired angle for advancement of the needle and hence chances of successful and safe subclavian cannulation.