• [ ] Set the bed angle at 45 degrees, neck muscles relaxed
• [ ] Ask the patient to remove their shirt
• [ ] Ask the patient to look to the left (if you’re on the right side of the bed)
• [ ] Crouch down and look for the jugular vein flickering on the neck - Anatomically, the internal jugular vein lies between the sternal & clavicular heads of sternocleidomastoid, but the movement of the venous column may sometimes be seen more clearly lateral to the muscle.
• [ ] You know it’s the IVJ when:
  • [ ] There is a double waveform pulsation (palpating the contralateral carotid pulse will help)
  • [ ] You can occlude it with your finger
• [ ] Measure the JVP - vertical height of flickering column of blood within the vein, above the sternal angle. JVP normally <4cm → Comment on the height!