With the short axis technique: We use a technique to keep the echogenic needle tip in the middle of the vein (watch the flush of blood) while moving the probe slightly proximally with the direction of the vein and keeping advancing the catheter with the needle, and with less than 1 cm of distance (the more is better) between the poking site and the probe (to make it clear again - we have to keep it in the middle), by that time, it will be very easily to advance the plastic cannula and remove the needle, it has the highest successful rate of insertion without kinking the catheter or the cannula !
it can not be stressed enough the biggest hurdle to overcome is learning the art of finding the needle tip!! then following it. angling the transducer is sometimes a nice trick to seeing the needle tip. differentiating between artery and vein is a must but also note that when a vein doesn't compress you might be dealing with a thrombosed vein. class dismissed nice video
Ive placed DOZENS of IVs (with US) that were greater than 2cm. Last one was 2.5cm. Had to use a 2.5in 18g needle though. Im kinda confused on how there were no successful lines placed at 1.6cm or greater. I literally do it all the time.
US guided venous/arterial access should be used more often, would reduce pneumothorax (central line/port) placement, AV fistulas, and other complications. it's like hiring a highly skilled sniper with pin point accuracy
and i'd also add sterile gel and covering the probe with sterile cover would be nice as people learning on live patients/co-workers tend to get gel (NON-STERILE) in contact with the catheter (and sometimes the probe) i cringe when i see people learn. way too cavalier. AV fistula is not pleasant when it's not hemodialysis intended!
