I really enjoyed the video. I hope you do more of them. What is the process for the actual sticking of the pt. Do you wipe the gel off first? Do you search for valves? Would there be an advantage for using the deeper veins vs the peripheral? I would like to see the US used more in critical care... especially the difficult sticks. Great video.
Overall good presentation. I don't know why you recommend the "wiggle test" when you could just move the probe back and forth to verify the presence of the "Hyperechoic" metallic needle tip. Wiggling the needle around in a small vein is not sound technique.
Great job. Were you really at Crozer? Mark the great US tech originally taught me. I was looking for some tips on getting a good sagittal view, which always seems a struggle.
Hi there, thanks for your videos. That helps me a whole lot and saves a lot of unnecessary stick for my patients. Please post any other great videos for nurses.
HI, someone from Frontier Nursing University wrote me for permission to use my videos. I am a graduate of that school and please feel free to use my video and contact me for any addition information you need.
Thanks for the video! One quick question, what is the orientation of the US probe when you switch from short to long axis? I assume that the probe marker is facing towards you.
Your video is great. Pretty much shows how we do it with the except that our USs can be set at 2cm depth, and because of our high proportion of chemo and transplant patients, we have better success by following our needle all the way to the hub because of failures that occur when the cannula is advanced too soon through tough skin, or because the veins patients who have been on prednisone long term are friable). Anyway, We were recently discussing whether one can visualize valves with the transverse view. Our team does something like 1200 IVs a month, many of which are US guided. Sometimes we see whitish ghosts within the lumen and have had patients report pain as the cannula is advanced through these ghosts. we have also have had catheters fail to flush after clean insertions, seemingly because the tip is against a valve. Any thoughts about that? it does appear that valves are obvious via the sagittal view, but only on the internets, rather than in real bedside assessments. Finally, it might be helpful to do a video on vein selection on small kids and infants. Thanks.
This is a great video, do you have a download link for the powerpoint? I would really like to present it to the educators in my Emergency Dept as right now I am the only one in the department utilizing utz to start lines. Thanks!
I was trained to follow the tip of the needle in all the way....meaning I cannulate the entire length of the vein with the need in place while following the tip with the probe ensuring it stays in the center of the vein. Have you used this technique? Also, I find I am more successful using this technique. Do you have any evidence that one way is more effective than the other?
We're living in a parallel universe. Your lecture is virtually identical to mine (Yours was developed first BTW). Items like the tegaderm probe cover/ sterile gel and aligning the patient/needle/ US machine I picked up over the years, this is the only online course I've seen that mentions them. I have not put together a slide/video presentation like yours as yet. But it appears I won't have re-invent the wheel. Thanks! We may want to incorporate this in to our institution's program. We'd like permission to do so from you. One minor point for floor patients in particular: most have been stuck multiple times prior to use of an US guided IV. I advocate local anesthesia for this population. Also helps with initial sticks in the ED when large bore catheters are required and the patient is not in extremis.(e.g. GI bleeds that haven't crashed). They tend to stay still, making the procedure easier for both the operator and patient. Especially since with the US technique needle movement tends to be a tad slower than a quick surface vein technique.
Excellent learning tool USG guided IV technique. Fine points explained very well. Very good for beginners.
Many tips I had not heard before or perhaps not explained as well as you have done in this video. Super,thanks so much.
Outstanding video! I'm beginning to learn US for IV placement, and this has been a fantastic supplement to our training!
An excellent presentation, thank you. I will share with my staff
Greetings from an ER in NE Montana. Thanks for the vid!!
what a great illustration ! thank you very much
Very good video. Very appreciate that you share your experience with everyone.
very informative teaching video with very practical tips. Thanks a lot.
Outstanding lecture and pearls.
Great presentation about doppler. Thank you
Needle guides were made for a reason. I would use them on every brachial access.
Very concise. Materials ordered. Good stuff😁
Excellent video
Excellent demo, I love it, thanks
very nice of you! thank you!
Great video. Thank you!
Great lecture (y)
tq so much
Great tutorial
Thank you! Cheers!
I really enjoyed the video. I hope you do more of them. What is the process for the actual sticking of the pt. Do you wipe the gel off first? Do you search for valves? Would there be an advantage for using the deeper veins vs the peripheral? I would like to see the US used more in critical care... especially the difficult sticks. Great video.
This was helpful! Big thanks from a Seattle ED RN!
Thank you!
your are really excellent
Thanks for the info.
Overall good presentation. I don't know why you recommend the "wiggle test" when you could just move the probe back and forth to verify the presence of the "Hyperechoic" metallic needle tip. Wiggling the needle around in a small vein is not sound technique.
Great point!
awesome!
Thank u very much
You are most welcome
Siegfried Emme! Blast from past (Crozier, I think)!
Great job. Were you really at Crozer? Mark the great US tech originally taught me. I was looking for some tips on getting a good sagittal view, which always seems a struggle.
Hi there, thanks for your videos. That helps me a whole lot and saves a lot of unnecessary stick for my patients. Please post any other great videos for nurses.
HI, someone from Frontier Nursing University wrote me for permission to use my videos. I am a graduate of that school and please feel free to use my video and contact me for any addition information you need.
Thanks
👏👏👏👏👏
Thanks for the video! One quick question, what is the orientation of the US probe when you switch from short to long axis? I assume that the probe marker is facing towards you.
Disregard, I've found the answer in other videos. Yes the marker is facing you, for other viewers. Thanks again!
Your video is great. Pretty much shows how we do it with the except that our USs can be set at 2cm depth, and because of our high proportion of chemo and transplant patients, we have better success by following our needle all the way to the hub because of failures that occur when the cannula is advanced too soon through tough skin, or because the veins patients who have been on prednisone long term are friable). Anyway, We were recently discussing whether one can visualize valves with the transverse view. Our team does something like 1200 IVs a month, many of which are US guided. Sometimes we see whitish ghosts within the lumen and have had patients report pain as the cannula is advanced through these ghosts. we have also have had catheters fail to flush after clean insertions, seemingly because the tip is against a valve. Any thoughts about that? it does appear that valves are obvious via the sagittal view, but only on the internets, rather than in real bedside assessments. Finally, it might be helpful to do a video on vein selection on small kids and infants. Thanks.
👍👍👍👍👍👍👍
This is a great video, do you have a download link for the powerpoint? I would really like to present it to the educators in my Emergency Dept as right now I am the only one in the department utilizing utz to start lines. Thanks!
I was trained to follow the tip of the needle in all the way....meaning I cannulate the entire length of the vein with the need in place while following the tip with the probe ensuring it stays in the center of the vein. Have you used this technique? Also, I find I am more successful using this technique. Do you have any evidence that one way is more effective than the other?
never lose the tip is the bottom line. Once I see the tip in the center of the vein I thread the catheter.
We're living in a parallel universe. Your lecture is virtually identical to mine (Yours was developed first BTW). Items like the tegaderm probe cover/ sterile gel and aligning the patient/needle/ US machine I picked up over the years, this is the only online course I've seen that mentions them. I have not put together a slide/video presentation like yours as yet. But it appears I won't have re-invent the wheel. Thanks!
We may want to incorporate this in to our institution's program. We'd like permission to do so from you. One minor point for floor patients in particular: most have been stuck multiple times prior to use of an US guided IV. I advocate local anesthesia for this population. Also helps with initial sticks in the ED when large bore catheters are required and the patient is not in extremis.(e.g. GI bleeds that haven't crashed). They tend to stay still, making the procedure easier for both the operator and patient. Especially since with the US technique needle movement tends to be a tad slower than a quick surface vein technique.
+Robert Molyneaux
Feel free to use whatever you would like. My lecture is being used all over the world already to teach people which was my purpose.
Thanks!
I wrote a post on how to make a ultrasound model here bit.ly/21TmAub Siegfried Emme FNP
🤝🤝🤝👏👏👏