Question JVD assessment

Emergency RN · Dec 15, 2009

The arteries should be pulsatile. If not you have a lot more problem than just JVD.

caringwldflwr · Dec 15, 2009

Thank you. That confirms what I thought. So, if I understand correctly, when doing JVD assessment, if I see pulsation in what I am looking at, I am either seeing the carotid(s) OR there's a much bigger problem than JVD. Right?

Emergency RN · Dec 15, 2009

Thank you. That confirms what I thought. So, if I understand correctly, when doing JVD assessment, if I see pulsation in what I am looking at, I am either seeing the carotid(s) OR there's a much bigger problem than JVD. Right?

LOL, what I meant was, if you're looking at the carotids, which should be pulsating, and they're not, your patient is dead; you should start CPR...

Seriously, the only time that Jugular veins will be pulsatile like that is if the patient had a tricuspid valvectomy without replacement; Right Ventricular pressure waves will backwash up the venous system. You'll then see the Jugular veins rapidly inflate and deflate, synchronous with the radial pulse. But if you want to perform a JVD test, look here (I'm too tired to type):

http://www.fpnotebook.com/CV/Exam/JglrVnsDstntn.htm

Also, I wouldn't be too hasty or aggressive about pressing on someone's liver or abdomen. Instead of inducing a HepatoJugular Refux, one may induce vomiting instead... :eek:

BTW: something else you can look up is cannon A waves (when the atria contracts against a closed tricuspid & back washes into the venous system)

Aymese · Dec 16, 2009

Also, just to add to the discussion, it is a normal finding to have JVD when assessing a supine patient. It becomes abnormal if it is still present when the patient is sitting up. Measuring how many cm the top of the distended vein is from the sternal notch + 5 cm is an estimate of RA pressure.