Im a new grad ICU nurse (A nurse for less than a year). Friends of mine are pros at doing ultrasound IVs. They have now parted this knowledge on me. I freaking love placing them. Recently I was blessed with only having 1 patient in the ICU who was relatively stable. I literally asked every nurse what access they had and if they wanted another IV. There is not better feeling than getting in a long 18g IV in that you can literally draw labs from without even putting on a TQ. Great video!
The purpose of walking it in is to make sure the tip is actually in the vessel before inserting the catheter. Sometimes you may have the tip of the needle inside the vein without having the catheter part in. This is why there are times where we get blood but are unable to advance the catheter into the vein. Therefore, walking it a bit will make sure the catheter part is in the vein. Not sure if you want an explanation for it, but I got nothing better to do right now.
I get an acoustic shadow due to the needle (with big size catheters) and then i cant see the vein below that. What can i do to troubleshoot that. Is it because i dont only see the bevel of the needle?
I’ve been learning different techniques from several different preceptors and find everyone does it kind of differently. What is your recommendation on how far back to insert your needle from the probe and do you keep the needle at same angle for insertion no matter the depth of the vein? My newest preceptor has been trying to instruct me to insert my needle further back from the probe as the veins gets deeper and to drop my probe and advance when I get blood. I was doing well prior to starting w another preceptor but now I’m unsuccessful with many first attempts when I’m being instructed to do it this way. He then will take over and insert the iv on the pt and I’m unable to learn what I didn’t do correctly or attempt again. I’ve kindly expressed to him that some part of this technique is not working but he continues to instruct me to do these things…move my needle back, don’t move the probe, once I’m in the vein check for blood return and advance…and surprise I can’t advance it 🤦🏻♀️ a bit frustrating as the previous weeks before I was successful with >90-100% insertions.
i usually go with 45º angle so if the target is at 2cm deep i start 2cm off the probe, when i get flashback i lower the angle to 20º and advance a little more and then introduce the catheter. But it depends on the depth of the vein and the lenght of the abbocath
Can you give tips on how to better see the tip of the needle? I took a class yesterday and it was hard for me to distinguish between the white dot and other white matter on the screen
Best advice is to: one stick right under the mid-line of the probe (usually marked with a line) so the dot will show up in the middle of the screen.Second is to track it proximal/distal- lets you see if it disappears (it will if needle) and finally, if you're not seeing a dot at all, fan (change the probe angle to the skin along the probe's long axis) so you can get the needle at 90 degrees to the probe. Hope that helps! Disclaimer: This is not medical advice, and should not be considered supervision of this procedure.
