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For external landmark technique, distance was measured between point of puncture (I) and sternal angle (B), which was noted as [X.sub.e], and catheter was fixed at that distance (Figure 1).
The top of the jugular venous column was 15cm vertically above the sternal angle of Louis, and rales were heard over both lungs.
Jugular venous pressure was measured at 2cm above the sternal angle and heart sounds were normal with no added sounds.