Ultrasound guided dynamic needle tip positioning in peripheral vein and artery cannulation 

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********* Contents of this video **************
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00:00 Intro
00:16 "To-and-fro method"
01:33 Demonstration of the effect of adjusting the incident angle on a simulator
02:32 "To-and-fro method" animation
03:22 "Needle blinking method"
04:38 Determination of the skin entry site
05:00 Demonstration of dynamic ultrasound-guided needle positioning on a simulator
06:51 Prevention of pathogen transmission via ultrasound probe
07:58 Ultrasound-guided needle repositioning
09:38 How to make a home-made simulator
10:59 Take-home Message
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As MAGIC guideline suggests, with the aid of ultrasound-guided technique, short catheters and midline catheters should be used more often instead of PICCs and CVCs in the case of difficult vascular access.
The dynamic needle tip positioning technique can be applied to ultrasound-guided cannulation of virtually all peripheral vessels, including hemodialysis arteriovenous fistula, upper arm vein for PICC and midline catheter, and radial artery for monitoring. One exception is calcified arteries (e.g., radial artery of dialysis patients): In such cases, the “needle blinking method” may not work because the ultrasound beam does not penetrate the calcified wall.
A nephrologist in Kyoto, Tadashi Kamata, MD
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