Derivation of a pediatric growth curve for inferior vena caval diameter in healthy pediatric patients: brief report of initial curve development.

Background: A validated tool has long been sought to provide clinicians with a uniform and accurate method to assess hydration status in the pediatric emergency medicine population. Outpatient clinicians use CDC height- and weight-based curves for the assessment of physical development. In hospital, daily weights provide objective data; however, these are usually not available at presentation.

Difficult central line placement due to variant internal jugular vein anatomy.

The internal jugular vein (IJV) is an optimal location for obtaining central venous access due to its superficial location. However, there are many potential pitfalls of using the landmark technique, including aberrant anatomy of the IJV, proximity to the carotid artery and cupola of the lung, body habitus, and prior neck surgery. Our case study demonstrates how the use of ultrasound greatly simplified cannulation of an aberrant IJV in a dialysis patient.