Central Venous Catheterization

To the Editor: I have three concerns about the description of central venous catheterization in the video by Graham et al. (May 24 issue). 1 First, it is misleading to describe the risk of hemothorax as “not applicable” when the internal jugular approach is used, since hemothorax is a known complication. 2 Second, head rotation of 45 degrees increases the overlap of the carotid artery by the internal jugular vein, 3 increasing the risk of arterial puncture. 4 For this reason, most authors recommend a near-midline position of the head. Third, the manometer technique that is shown is inadequate. Blood rising more than 30 . . .