Measuring the Jugular Venous Pressure: Do Not Turn the Head!

The Reply

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Thank you for inviting a response to the letter from Dr Jolobe concerning our article. 1 We share his concern that some of our colleagues and trainees have become cynical about the usefulness of jugular venous pressure assessment in the current era of acute medicine. Junior doctors may be more likely to rely on tests (formal echocardiogram, chest X-ray, natriuretic peptide level) or response to diuresis prior to diagnosing congestive heart failure.

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The Life-Changing Implications of Evaluation of Jugular Venous Pressure

“…its details, 1 can be a matter of life-changing, if not life-saving, importance. The details that matter most include the precaution to relax the neck muscles, encapsulated in the warning "Do not turn the head", 1 which I have previously taken the opportunity to champion, 2 notwithstanding prevailing received wisdom to the contrary.…”

“…its details, 1 can be a matter of life-changing, if not life-saving, importance. The details that matter most include the precaution to relax the neck muscles, encapsulated in the warning "Do not turn the head", 1 which I have previously taken the opportunity to champion, 2 notwithstanding prevailing received wisdom to the contrary. 3 Also crucial to mitigating the risk of overlooking the presence of raised JVP is the invocation to flex the trunk "to whatever angle makes the wave form most obvious," 1 because that may be the diagnostic maneuver pivotal to generating the "right angle" for eliciting a raised JVP.…”