Supraclavicular approach to the subclavian vein

The supraclavicular approach allows ready access to the subclavian vein. The point of needle entry lies 1 cm posterior to the sternocleidomastoid and 1 cm superior to the clavicle. Be sure the angle of the needle is depressed 10 to 15 degrees below the coronal plane (ie, needle tip aimed upwards). Advance the needle behind the medial clavicle along a trajectory directed just below the contralateral nipple.