Shoulder Manipulation to Facilitate Central Vein Catheterization from the External Jugular Vein

Manipulation of the shoulder to facilitate passage of J-wires past the clavicle during external jugular vein catheterization was tested prospectively in 111 adult patients undergoing cardiac surgery. On 10 of 25 occasions when the wire would not pass into the thorax, manipulation of the shoulder then allowed the wire to pass.