POCUS - Vascular Access Flashcards
Always hold the transducer ___________.
with your hand stabilized on the patient
Adjust your needle with ______________.
small, controlled movements while you are visualizing (or attempting to visualize) the tip
What is the hydrodissection technique?
Infusing a small amount of saline when you are stuck on the edge of the vessel to liberate any tissue you are stuck on and ease the entry into the lumen.
When you have the option, always scan both ___________ before selecting your site of entry.
sides (right and left)
Often one can be dramatically more accessible.
The two transducer views that you can use to insert a needle are ________________.
in-plane (longitudinally along the vessel) or out-of-plane (perpendicular to the vessel)
These are also called short axis (in-plane) and long axis (out-of-plane).
Never advance your needle if __________.
the tip is not visualized
The closer you are to ____________, the easier your needle will be to see.
(This is an angle.)
perpendicular
If you’re having trouble finding your needle tip, look at the angle of your needle entry and your probe and try to make them perpendicular.
When you are doing a semi-sterile technique (such as with an A line), be sure to put down a ______________.
sterile drape to place the US with the sterile cover on
If you are using a sterile cover you should have a sterile area to place it on.
When you switch to long axis, have the indicator dot pointed _______________.
toward you
With your left hand on the probe, you will be advancing the needle with your right hand toward your left. It mentally makes sense to have the dot toward you because then the needle comes in from left to right (while you are advancing with your right toward your left).
ALSO, with the dot toward you, you have an indicator of the exact middle of the long axis of the probe which helps you to know where to put your needle.
It’s crucial that your axis of entry is ____________ to the axis of the probe.
perpendicular
If your axis of entry is not 90º to the probe, then you will go off axis. This applies to both short and long axis views.
Describe the cut-cap technique to reduce posterior wall penetration.
Calculate the depth of your posterior wall and use the Pythagorean theorem to find the maximum length of needle needed. Cut that length off of the needle cap to ensure you don’t go too far.
Which vein is more latera, bascilic or cephalic?
Cephalic is lateral
For PIVs, you should cover the transducer with ____________.
a sterile tegaderm
Why should you consider a steeper angle for PIVs than central lines?
The catheter length in PIVs is shorter and if you sacrifice a lot of it by using a shallow angle then it is more likely to extravasate.
True or false: because of their placement in deep tissues, US guided PIVs are less likely to dislodge.
False
The extra tissue depth actually makes it more likely.
