Once you have the guidewire into the jugular, nick the skin with a scalpel. It reduces the friction on the introduce sheath and gives a smoother entry. I find it easier to "pill roll" the introducer between thumb and index finger while advancing into. Much smoother entry. Head down, feet up unless in congestive failure.... Etc...
#9 Once worked a place where the residents had to put their wire in plastic baggie after the procedure and show it to their attending. No one ever forgot the wire. 😂
A string of ectopics or what can look like electrical interference. Anything that doesn't look right basically. let the person know putting the wire in and they can withdraw slightly.
I am in intern and i already put 2 central lines but yesterday while putting central line the patient was moving too much and hue to tha jugular was moving too much left and right.
Preparation is key. If the patient is too agitated but you really need to central line then the smallest amount of sedation you can get away with should be considered.
Hope you find this useful. Please let me know of any other tips you might have.
About Ultrasound tips
thank you very helpfull , but some tips are notspecifically in central line procedure only , but all critical procedure , thank you very much
Once you have the guidewire into the jugular, nick the skin with a scalpel. It reduces the friction on the introduce sheath and gives a smoother entry.
I find it easier to "pill roll" the introducer between thumb and index finger while advancing into. Much smoother entry.
Head down, feet up unless in congestive failure.... Etc...
#9 Once worked a place where the residents had to put their wire in plastic baggie after the procedure and show it to their attending. No one ever forgot the wire. 😂
Thank you very much I don't know what I'm doing wrong on subclavian my wire always gets stuck and I have to abandon the whole thing.
Any tips on the ecg while central line insertion? What are we looking for?
A string of ectopics or what can look like electrical interference. Anything that doesn't look right basically. let the person know putting the wire in and they can withdraw slightly.
Amazing!
Great material. Thanks
I am in intern and i already put 2 central lines but yesterday while putting central line the patient was moving too much and hue to tha jugular was moving too much left and right.
Preparation is key. If the patient is too agitated but you really need to central line then the smallest amount of sedation you can get away with should be considered.
Are you a medical doctor? What is a critical care practitioner?
No I am not a doctor. I am an advanced nurse practitioner in critical care.
helped to modify my practice thanks a lot
Glad it helped.
great