On your own for an US guided central line?

by Bob Stuntz

One of the most common complaints I hear about US guided procedures is that many providers feel like you need to have multiple people in the room to set up your machine, equipment, and stay sterile at the same time.  Working in the ED, you know you don’t always have that luxury, so it is important to learn how to get yourself set up.  

The above links to a great video from Jason Nomura (@Takeokun) that shows you how to get your US probe sheathed while keeping everything sterile when you are on your own. 

Some US guided procedure pearls:

- Always have your US machine in front of you, not behind you.  Same goes for your equipment.  You want to make sure you have your machine within your line of sight. 

- Keep your US probe indicator matched up with your screen no matter where you are on the body.  Indicator on the screen on the left, probe indicator to your left.  

- Don’t forget the gel between the probe and the sheath.  As in the video, set your probe in its holder and place a layer of gel on it prior to getting sterile so you don’t need someone else to do it.  

- Before you get sterile, always preview your procedure site.  For vascular access, make sure you have a good, compressible vein to access before you get all gowned up for nothing.  

- And remember: ALWAYS keep your needle tip in view!