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2Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 3Associate Editor, JAMA 4Department of Community Health Sciences, Boston University School of Public Health, and Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Grayken Center for Addiction, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts JAMA. Published online February 25, 2021. doi:10.1001/jama.2021.0958

Case Summary A previously healthy man, intubated in the intensive care unit (ICU) for respiratory failure due to coronavirus disease 2019 (COVID-19), required central venous access for vasopressor infusion. The intensivists were occupied managing other critically ill patients, so an available intern attempted to place a triple-lumen catheter in the right internal jugular vein using only anatomic landmarks for guidance. When the access needle was inserted, pulsatile return of blood was noted. What Should Be Done Next? Remove the needle and hold pressure. Place a small single-lumen catheter to ...

1.  The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. US Dept of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. 2.  Women and Smoking: A Report of the Surgeon General. US Dept of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2001. 3.  How Tobacco Smoke Causes Disease: The Biology and Behaviora...