A VERY COOL TOOL FOR CENTRAL LINE PLACEMENT

A VERY COOL TOOL FOR CENTRAL LINE PLACEMENT // There's something in your central line kit that you may not have to noticed befe and it's a GAME CHANGER. It's a needle with catheter will change the game in how you place central lines. Watch this video and learn about this awesome little tool.

Have you used this magical piece of central line equipment? Let me know in the comments section below. If you enjoyed the video please give us a like and if you want to see more, please subscribe so you never miss any great content.

Stay awesome

[halfdanbau-madsen]

Also great in the case of a crashing patient that doesn't have peripheral access. You can use that catheter to administer code meds mid-procedure, and then proceed with inserting the definitive central line without having to regain access to the vessel. Great video.

[katelinmorrissette]

Also like it for troubleshooting when your wire hits resistance. Really easy to re-confirm good blood return so that you can re-attempt to place your wire without doing a 2nd stick.

[vkab]

I had difficulty visualizing the angiocath under ultrasound.that was why I had abandoned it. Worked well for me with the landmark technique prior. Looking forward to your video demonstrating its use under ultrasound guidance.

[RandeeRoe]

Do you hub the cath, remove the needle, and then advance the wire through the cath alone?

[juanmanuelcastillo]

I am missing this guy here in Colombia. the kit doesn't have it. I was trained in Canada with this one.

[TabanjaTabr]

thank you for your thoughts about teaching novice trainees in this field. I agree that the lack of motor skills is likely to fail the steel needle technique.

[miguelromano]

Great video and tip. But do you have any experience in Syringeless CVC Placement?

[allibutler]

Do you have any experience using the EKG saline conduction method to confirm central venous catheter tip location?

[MD.fitness.]

I usually use the steel introducer needle. Tried the angiocath yesterday. I was able to thread the angiocath into IJ. I don’t know what happened but I was not able to threadthe guide after that. For some reason the angiocath kinked in the soft tissue and it was very positional if I straightened it out slightly blood would flow otherwise it wouldn’t. I tried couple of times and then just took it out and did it with the regular way. Has this happened to you and any tips for avoiding it?

[jonchoi]

I like to place it over the guidewire and then remove the guidewire. Then I hook it up to an arterial line tubing to make sure it is not pulsatile ( and not in the carotid artery).

[farhanqadeer]

We can use that to confirm placement. Vein versus artery especially in hypoxic and hypotensive patient where you might not get bright red color blood with pulsatility.

[diatriesoerjodibroto]

I have never figured out what they are for..thanks a lot...

[Medic]

In the infrequent case that you get the angiocath into the vein but for some reason (usually an anatomic anomaly) you cant get the wire in deep enough to place the TLC, you can secure this and at least have SOME access in the meantime while working on more definitive access.

[informedconsent]

I was placing a right IJ today using the steel needle and typical frustrating BS. I got into the vessel and drew venous blood into the syringe, detached the syringe and went to pass the wire. It went ok for a little distance then inexplicably stopped and I couldn't pass the wire any further. I was thinking I would have to abandon the site and wondering how I could salvage it then I saw the IV catheter sitting there. I threaded it over the wire to its hub then withdrew the wire and reloaded it into its plastic guide and this time was able to pass it successfully through the IV and place the triple lumen. When I got home I looked on YouTube to see if anyone else uses the catheter and lo and behold I found your video. Next time I think I'm going to go straight to the IV catheter and skip the steel needle. Thanks for your video.

[tariqjaber]

Do you have a video of how to place it?

[rtexmx]

Multiple pluses/uses:
-If you need to get a case going and the wire just doesn't want to advance due to some stenosis, but you clearly have forward flow on doppler, you can get the case going with the 18ga cath. Then futz with the CVC later.
-If you used the introducer needle initially, but again the wire won't advance easily, exchange the needle for the catheter over the wire. Slide the catheter in completely, then pull the wire "J" into the catheter and readvance the wire. Most of the time the wire will pass the obstruction.
-Not sure if you're in a vein or artery (e.g. sickle cell patients have bright red venous blood), attach an IV extension tubing (~40cm), pull back a few cm's of blood and hold up the tubing. Called tube manometry. If it is squirting off the walls and ceiling it's an artery. If it is <40cm/H2O it will stay in the tubing and have respiratory variation, it's in a vein.

[drwalthermd]

I believe this is a smaller guage needle than the steel harpoon, SO, IF you were to tap the artery, less damage has been done, and hemorrhage would presumptively be less. Note: I trained before the advent of U/S so my early experiences with this catheter were predicated upon a landmark technique approach.

[MD.fitness.]

I usually use the steel introducer needle. Tried the angiocath yesterday. I was able to thread the angiocath into IJ. I don’t know what happened but I was not able to threadthe guide after that. For some reason the angiocath kinked in the soft tissue and it was very positional if I straightened it out slightly blood would flow otherwise it wouldn’t. I tried couple of times and then just took it out and did it with the regular way. Has this happened to you and any tips for avoiding it?