During an infraclavicular subclavian vein cannulation, the needle is inserted below the clavicle at a specific point and advanced medially behind the clavicular head of sternocleidomastoid. The usual skin entry point is:

• A Junction of the lateral and middle thirds of the clavicle, just below its lower border
• B Midpoint of the clavicle, 2 cm above its upper border
• C Junction of the medial and middle thirds of the clavicle, just below its lower border ✓
• D Just lateral to the sternal end of the clavicle, above its upper border

Explanation

The subclavian vein runs behind the junction of the medial and middle thirds of the clavicle, so the needle enters at that point just beneath the clavicle and is aimed toward the suprasternal notch. Entry too far laterally risks pneumothorax because the dome of the pleura and lung lie behind the lateral third of the clavicle.

Reference: Gray's Anatomy for Students, 4th ed.

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Written and medically reviewed by the StethoPrep medical team.