How to determine the location of central venous puncture from internal jugular vein, preferably with pictures? Thank you~

In general, right internal jugular vein puncture is the most commonly done, because the left lung tip is slightly higher than the right, and the risk of lung rupture caused by puncturing the left internal jugular vein is higher. Let the patient lie on the pillow, tilt his head to the left and lift his head slightly upward. You can generally see the connecting line between sternocleidomastoid muscle and sternocleidomastoid muscle triangle. Near the apex of the sternocleidomastoid triangle, touch the right internal carotid artery with the left index finger and middle finger, adjust the gesture to make the two fingers close together, and the fingertips are on the artery, so as to determine the direction of the artery, and then make a right triangle with the centers of the two fingers. The point on the right can be used as the puncture point. The direction of the puncture needle is parallel to the artery or towards the right nipple, and at the same time, it makes a downward angle with the skin of 15-30 degrees, and the needle is withdrawn until the venous blood is successfully withdrawn.

After proficiency, you can press the left index finger nail vertically on the right edge of the internal carotid artery, and then insert the needle parallel to the artery downward into the nail. I think it's easier to operate and less likely to damage arteries and other tissues.

It's not difficult to do it a few more times. Medicine is a very practical subject. Practice makes perfect. Generally, anchor points are set as needed within a certain range. The standard point in the book is actually found. Sometimes you can't find them unless you understand them.

I hope to have some reference for you.