Podcast 836: Humming to get EJ

<p><strong>Contributor: Jared Scott, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Two conventional ways to aid in external jugular vein (EJ) catheter placement are Trendelenburg’s position and Valsalva’s maneuver by patient </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">One study compared ultrasound visualization of cross sections of EJ and common femoral vein at baseline and with patients in Trendelenburg's position, Valsalva's maneuver, and while humming</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">The study found all three conditions distended the veins from baseline, but there was no significant difference in diameter between the conditions  </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Humming may be a viable technique in distended EJ for catheter placement, and may be easier for patients to comprehend than Valsalva </span></li> </ul> <p> </p> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Lewin MR, Stein J, Wang R, et al. Humming is as effective as Valsalva's maneuver and Trendelenburg's position for ultrasonographic visualization of the jugular venous system and common femoral veins.</span> <em><span style="font-weight: 400;">Ann Emerg Med</span></em><span style="font-weight: 400;">. 2007;50(1):73-77. doi:10.1016/j.annemergmed.2007.01.024</span></p> <p> </p> <p><em><span style="font-weight: 400;">Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD</span></em></p> <p> </p> <p>In an effort to promote diversity, equity, and inclusion in Emergency Medicine, The Emergency Medical Minute is proud to present our 2nd annual <em>Diversity and Inclusion Award</em>. We support increasing the representation of underrepresented groups in medicine and extend this award to individuals applying to emergency medicine residencies during the