“ Patients do not die from a "failure to intubate." 'They die either from failure to stop trying to intubate or from undiagnosed esophageal intubation.” Scott, DB Endotracheal intubation: friend or foe Br Med J (Clin Res Ed). 1986 Jan 18;292(6514):157-8.
Action tips 1.Prep skin For IJ , prep extend to SC 2. Prep cathetor Flush with Saline 3. Locate vein with finder needle IJ ~ 3 cm. 4. Remove finder needle Cap lock !! 5. Insert introducer needle Traction skin for fix landmark 6. Remove syringe : air embolism Don’t remove hand at all. 7.Insert guidewire Guide dislodge inside pt. or other damage with force. 8. Stop guidewire at 10 cm + skin mark Or when you see ectopy ! Heard arrhythmia. 9. Never let go of the guidewire. 10. Verify tip In SVC not in RA , above azygous v. an d carina. With tip parallel to vessel wall.