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Techniques: Jugular Venous Pressure Measurement (JVP)
The technique for examination for CVP (central venous pressure)
- Patient reclining with head elevated 45 °
- Measure elevation of neck veins above the sternal angle (Lewis Method).
- Add 5 cm to measurement since right atrium is 5 cm below the sternal angle.
Normal CVP <= 8 cm H2O
- Light should be tangential to illuminate highlights and shadows.
- Neck should not be sharply flexed.
- Using a centimeter ruler, measure the vertical distance between the angle of Louis (manubrio sternal joint) and the highest level of jugular vein pulsation. A straight edge intersecting the ruler at a right angle may be helpful.
Note: Ability to measure jugular venous pressure will be difficult if pulse is >100 per minute.
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- If the internal jugular vein is not detectable, use the external jugular vein. The internal jugular vein is the preferred site.
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Distinguishing the internal jugular vein pulsations from the carotid artery
| Jugular Vein |
Carotid Artery |
| No pulsations palpable. |
Palpable pulsations. |
| Pulsations obliterated by pressure above the clavicle. |
Pulsations not obliterated by pressure above the clavicle. |
| Level of pulse wave decreased on inspiration; increased on expiration. |
No effects of respiration on pulse. |
| Usually two pulsations per systole (x and y descents). |
One pulsation per systole. |
| Prominent descents. |
Descents not prominent. |
| Pulsations sometimes more prominent with abdominal pressure. |
No effect of abdominal pressure on pulsations. |
Proceed to the next technique
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