Question

hob needs to be up at 45 degree angle, to measure jvp.

leslie

But why?

This is from Jarvis:

From the jugular veins you can assess the central venous pressure and thus judge the heart's efficiency as a pump.

The internal jugular vein is attached more directly to the superior vena cava and more reliable for assessment. You cannot see the internal jugular vein but you can see its pulsation.

Postion the person supine anywhere from a 30- to a 45-degree angle, wherever you see the pulsations.

The higher the venous pressure is, the higher the position you need.

Remove the pillow to avoid flexing the neck.

As the person is raised to a sitting position, the external jugulars flatten and disappear, usually at 45 degrees.

Full distended external jugular veins above 45 degrees signify increased CVP as with heart failure.

You must be able to distinguish internal jugular vein pulsation from that of the carotid artery.

Think of the jugular veins as a CVP manometer attached directly to the right atrium. You can "read" the CVP at the highest level of pulsations.