Ultrasound-guided central line training

Ultrasound-guided central line training teaches you to place a central venous catheter while you watch the vein, the artery and your needle on screen. It is now the expected way to place an internal jugular line. This guide explains what NICE expects, the core scanning and needle skills, and how to build competence.

It is general education, not a protocol. Always follow your hospital's central venous access policy and supervision rules.

What NICE expects

NICE technology appraisal guidance 49, Ultrasound locating devices for placing central venous catheters, sets out the standard. Its audit criteria, checked on 13 November 2026, say that:

• two-dimensional ultrasound guidance is used when a central venous catheter is inserted into the internal jugular vein in an elective situation;
• everyone who places central venous catheters is trained in two-dimensional ultrasound guidance;
• audio-guided Doppler is not used for insertion.

The same criteria suggest extending ultrasound guidance to central lines placed for any purpose, elective or emergency, as its use grows.

The core skills

1. Scanning the neck. Tell the internal jugular vein from the carotid artery by compressibility, shape and Doppler, and check the vein is open and free of clot.
2. Choosing a view. Know when to use a short-axis (out-of-plane) or long-axis (in-plane) view and the risks of each.
3. Needle tip tracking. Keep the needle tip on screen at all times, not just the shaft.
4. Confirming the guidewire. Scan to confirm the wire is in the vein before you dilate.
5. Asepsis. Use a sterile probe cover and gel, and full barrier precautions.
6. Complications. Know how to recognise and respond to arterial puncture, pneumothorax and a lost guidewire.

How to build competence

Start on simulation models to learn hand-eye coordination with the probe and needle. Then do supervised procedures until your hospital signs you off. Keep a logbook of every line you place.

Our central venous access course in Manchester

The Ultrasound-Guided Central Venous Access Course is a half-day, face-to-face course in Manchester with 4 CPD points. You practise vascular scanning and ultrasound-guided needle insertion on simulation models with feedback from our faculty, with online notes and a quiz before the day. A course is not a licence to practise: your hospital signs off competence.

Related courses: ultrasound-guided peripheral cannulation, chest drain and thoracocentesis and the Core Emergency Ultrasound (Level 1) course. See our POCUS training guide and all emergency ultrasound courses in Manchester.