Tips Get the best gain for the needle visualization and remember it, mine is 66 Decrease the depth to 2 cm or even less and increase the frequency to improve resolution and needle visualization If you direct the bevel of the needle up. it becomes more visible You don't need KY jelly on the skin, wet the skin with antiseptic solution just before you put the probe on the skin Steristrips are very good for securing the cannula
I feel ‘in-plane’ technique much better than 'out of plane' approach. Gets me there ‘first shot’ all the time! ‘Creep-up' technique is very useful even for central venous line insertion.
Nice review and useful info, but new ultrasounds with smaller narrow probe and drop down centerline really help over the previous wider block probe. Thanks
Indeed, if available. In many practices, folks have only a linear probe. Many popular, portable ultrasound machines have only one receptacle for one ultrasound probe, which makes multiple probes inconvenient to store, change, etc. But a great idea for another video - with a hockey-p probe. Best regards
In agree with the low angle approach for a needle only. But with the Arrow wire-needle-cath all in one device i intentionally go through the back wall with a high angle of approach then pull the needle back so the catheter tip is most distal then lower the angle and withdraw both needle and catheter together. when the cath tip pops int othe lumen advance the wire only of blood is pulsing up the device.
By ultrasound. IMO, the presence of both radial and ulnar arteries on ultrasound is adequate to rule out the risk of ischemia in case of radial artery spasm or thrombosis after radial artery cannulation. Best regards and Thank you for asking an important question.
Hi Marshima. An ideal angle is somewhere between 20 degrees and degrees for the radial artery catheterization. Puncture of the radial artery for blood gas collection is much different; a larger angle may be easier to a needle tip into the lumen (approx 45 degrees). Best regards
a problem I found when using US, is difficult centralization of the artery in the screen especially in thin patients and pediatrics. unfortunately, I do not have small probe.
Well I read in published paper that with biplane view (butterfly iq+) you you don’t even have to move probe along with needle. Very good for beginners aswell.Fucking awesome
Thank you for the feedback, Eduardo. Agree that a jelco 20g is sufficient in most patients. However, due to the extensive calcifications and small caliber arterial line in this patient, the choice of the Seldinger technique was a good one. Best regards to you and your colleagues.
E então modelos de simulação da técnica com US sem ser em pacientes? Meu sonho ter tido essa disponibilidade na faculdade ou atualmente na residência de Clínica kkk É realmente outra realidade. Ficamos com a nossa tupiniquim 🙃
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Tips
Get the best gain for the needle visualization and remember it, mine is 66
Decrease the depth to 2 cm or even less and increase the frequency to improve resolution and needle visualization
If you direct the bevel of the needle up. it becomes more visible
You don't need KY jelly on the skin, wet the skin with antiseptic solution just before you put the probe on the skin
Steristrips are very good for securing the cannula
All great tips!
Thank you
I feel ‘in-plane’ technique much better than 'out of plane' approach. Gets me there ‘first shot’ all the time! ‘Creep-up' technique is very useful even for central venous line insertion.
Agreed. In-plane can be tricky with small vessels that do not have a straight path. Best regards!
Bravo ! Thank you for the great tip about the angle of cannulation in plane !
Glad you enjoyed it! Greetings from NYSORA!
Thank you so much sir for your excellent and extraordinary video.. please keep sending as much as you can as it’s helping us like anything..
Nice review and useful info, but new ultrasounds with smaller narrow probe and drop down centerline really help over the previous wider block probe. Thanks
Indeed, if available. In many practices, folks have only a linear probe. Many popular, portable ultrasound machines have only one receptacle for one ultrasound probe, which makes multiple probes inconvenient to store, change, etc. But a great idea for another video - with a hockey-p probe. Best regards
Very good tips and so much details 😊 Thank you! Хвала пуно :)
Most welcome!
Very nice tips. Especially the one of piercing the artery with a lower angle!!
Hi there! Glad it was helpful!
Outstanding, as always! Thank you!
Our pleasure! Greeting!
Thank you thank you very much sir,
Nice video. Great tips!
Thak you Rex
Like always, great explained! Hvala puno
Hey Mai. Be.! Glad you like the video. Make sure you subscribe to the channel so that you do not miss some super educational upcoming videos!
Very useful
Thanks a lot
In agree with the low angle approach for a needle only. But with the Arrow wire-needle-cath all in one device i intentionally go through the back wall with a high angle of approach then pull the needle back so the catheter tip is most distal then lower the angle and withdraw both needle and catheter together. when the cath tip pops int othe lumen advance the wire only of blood is pulsing up the device.
Thanks 👍👍
Thank you for sharing this knowledge.
I want ask about how I can assess adequate collateral circulation better than Allen test.
By ultrasound. IMO, the presence of both radial and ulnar arteries on ultrasound is adequate to rule out the risk of ischemia in case of radial artery spasm or thrombosis after radial artery cannulation. Best regards and Thank you for asking an important
question.
Great job
Thanks!
What is the ideal angle for needle placement?
Hi Marshima. An ideal angle is somewhere between 20 degrees and degrees for the radial artery catheterization. Puncture of the radial artery for blood gas collection is much different; a larger angle may be easier to a needle tip into the lumen (approx 45 degrees). Best regards
a problem I found when using US, is difficult centralization of the artery in the screen especially in thin patients and pediatrics. unfortunately, I do not have small probe.
That is true. One method you can try is ZOOM.
Well I read in published paper that with biplane view (butterfly iq+) you you don’t even have to move probe along with needle. Very good for beginners aswell.Fucking awesome
Have u tried using the biplane function for butterfly iq+? How did u find it?
Be very careful using the creep up technique. It once got me arrested in Chattanooga.
Cateter Seldinger para canulação de arteria?! Nunca vi nem comi eu só ouço falar😢 sempre no jelco20G… tristeza do Jeca
Thank you for the feedback, Eduardo. Agree that a jelco 20g is sufficient in most patients. However, due to the extensive calcifications and small caliber arterial line in this patient, the choice of the Seldinger technique was a good one. Best regards to you and your colleagues.
E então modelos de simulação da técnica com US sem ser em pacientes? Meu sonho ter tido essa disponibilidade na faculdade ou atualmente na residência de Clínica kkk
É realmente outra realidade. Ficamos com a nossa tupiniquim 🙃
Very useful
Glad to hear that!