18
[1] Subclavius muscle [2] Costocoracoid ligament [3] Costoclavicular ligament
Figure 5.
Entry point for percutaneous subclavian venipuncture
2.
Visually draw a line between St and Cp, and divide the segment into
thirds. The needle should pierce the skin at the junction of the middle
and lateral thirds, directly above the axillary vein (point Ax).
3.
Place an index finger on the clavicle at the junction of the medial and
middle thirds (point V), beneath which point the subclavian vein
should be located.
4.
Press a thumb against the index finger and project 1–2 centimeters
below the clavicle to shield the subclavius muscle from the needle
(when hypertrophy of the pectoralis muscle is apparent, the thumb
should project about 2 centimeters below the clavicle because the
subclavius muscle should be hypertrophied as well) (Figure 6
Location of thumb and needle entry on page 18).
Figure 6.
Location of thumb and needle entry
