Improving the “global use” of ultrasound for central venous access: a new supraclavicular scan by microconvex probe

Background Ultrasound (US) is increasingly used as a “global” tool to assist all the steps of a central venous catheter insertion procedure: choice of vein/approach, needle guidance during venepucture, prevention of primary malposition, rule out of pleural complications. While approach choosing and needle guidance are now well standardized, US-based prevention of primary malposition and rule out of pleural complications are still a matter of debate. US based prevention of primary malposition of a central catheter relies on [1-4]: rule out of catheter misdirection in the superior vena cava (SVC) tributary veins (so called “negative assessment”) identification of the tip within the right atrium and/ or in the lower part of the SVC (so called “positive assessment”). Tip position may be evaluated: