Indeed, checking blood return is an essential procedure in CV line placement. But, putting too much priority on flashback can hamper efforts to visualize the needle tip on US screen. For a deeper insight into this topic, please go to https://doi.org/10.1186/s41100-016-0019-1 and view my article: “Ultrasound-guided cannulation of hemodialysis access”.
A nephrologist in Kyoto, Tadashi Kamata, MD
Video Index: Click on the blue type below to jump to a specific stage of the video.
00:00 Start
1. 00:16 Background
2. 01:10 Transverse vs. longitudinal
3. 01:32 Probe holding
4. 02:31 Needle holding
5. 02:54 Determination of puncture site
6. 04:20 In the soft tissue
7. 07:09 Push & stick
8. 09:33 Needle blinking
9. 11:36 Guidewire identification
10. 12:30 Actual case
11. 17:20 Difficult cases
12. 20:26 Troubleshooting
13. 21:30 Needle
14. 22:49 Guidewire
15. 23:05 Ultrasound machine
16. 23:40 Simulation training
17. 24:00 Video recording
*************** Relevant papers & videos ***************
Three tips for improving the ultrasound visibility of the needle tip.
https://youtu.be/7fxADjLICQ0
Thomas S, et al. “The vanishing target sign: confirmation of intraluminal needle position for ultrasound guided vascular access.” Acad Emerg Med. 2013 Oct;20(10):e17-8. https://onlinelibrary.wiley.com/doi/epdf/10.1111/acem.12228
Bondestam S. “The needle tip echo.” J Ultrasound Med. 1992;11:253-6
Kamata T, et al.“Ultrasound-guided cannulation of hemodialysis access. Ren Replace Ther” 2016; 2:7 https://doi.org/10.1186/s41100-016-0019-1
Kamata T, et al. “Visibility of guidewires in ultrasound-guided internal jugular double lumen catheterization” J Jpn Soc Dial Ther. 2012;45:475–82 (in Japanese). https://www.jstage.jst.go.jp/article/jsdt/45/6/45_475/_pdf
Ultrasound Guided Internal Jugular Vein Cannulation NEJM
https://youtu.be/hPPzFnGcLRs
Rapid IJ (aka Easy Internal Jugular Cannulation)
https://youtu.be/FjSmbUWXznY
Internal jugular central line insertion
https://youtu.be/fZyxzzn11QM
Ultrasound-guided internal jugular cannulation (short-axis approach)
https://youtu.be/PUyybCfli_E
Ultrasound Guided Subclavian Central Lines -- BAVLS
https://youtu.be/_VYHj4sRlkc
Ultrasound guided peripheral venous cannulation in an actual patient
https://youtu.be/8FnyzJzDYds