Currently there are numerous studies, including prospective randomized trials, comparing landmark and ultrasound guided placements of Internal Jugular(IJ) and Femoral CVC, both in the ED and in the ICU settings. However, there has not yet been a prospective randomized trial that has similarly looked at SCVC placement in the ED setting. There are a few studies looking at ultrasound guided SCVC placement performed in critical care settings, but these trials had methodological limitations. Recently, a large (401 patients), randomized, prospective study from an ICU in Greece was published in which the landmark approach was compared to ultrasound guided SCVC placement. The authors found that ultrasound guided SCVC was superior to the landmark approach in success rate, time to cannulation, and complication rates.