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How to perform a jugular cutdown | VETgirl Veterinary CE Videos Blog

In this VETgirl online veterinary CE blog, we demonstrate how to perform a jugular cutdown for intravenous (IV) catheterization. It's pretty rare to have to perform a jugular cutdown, but when in doubt, be prepared to do so! That's because critically ill patients may be so hypovolemic that it is difficult to obtain venous access. Traditionally, a jugular cutdown is only performed in patients where multiple attempts of venous catheter placement has failed (e.g., cephalic, lateral saphenous, etc.).

In this cadaver example, you can see that we used an #11 blade scalpel to perform the jugular cutdown. In patients that are moribund or semicomatose, sedation or local anesthesia is not required. Otherwise, a small  amount of lidocaine can be injected in the skin (not the jugular vein!) as a local anesthetic. Next, use aseptically prepare the skin .

Most importantly, don't cut the jugular vein (or important structures like the carotid artery, etc.). When making the incision, make sure to pull the skin laterally to the vessel so you are making an incision to the side and not directly over the jugular furrow or jugular vein.

Depending on the size of the animal, a small 1-3 cm incision should be made parallel to the jugular. Once down, manipulate the skin incision to see if you can localize the bluish/purple hue of the jugular vein. Some people advocate for slipping a small curved mosquito hemostat underneath the jugular vein to isolate it and allow for manipulation and positioning for catheterization. Most of the time, VETgirl just moves in to catheterize the vessel directly. Make sure to confirm placement, flush, secure in place, and suture appropriately (to close the skin and secure the catheter).

References:

1. Hansen B. Emergency venous cutdown. North Carolina State University blog.

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