Wk 6 US

Question 1

What is NALTA?

Answer 1

North star
Angle - go from shallow to 45
Leap Frog
Tent
Aspirate

=steps to US-guided short axis needle insertion

Question 2

What is tent?

Answer 2

When you reach the vessel wall and press on it, it “tents” downward just before puncturing it

Question 3

What is the view of short axis with needle guidance?

Answer 3

as a circle, the tip of the needle

Question 4

Which side of the probe is the needle inserted on to get short axis view?

Answer 4

longer side

Question 5

What is the long axis view?

Answer 5

Can see the needle from the side

Question 6

Which side of the probe is the needle inserted on to get the long axis view?

Answer 6

short side

Question 7

Pro tips

Answer 7

1. Center the vessel w/ probe
2. line the needle up w/ probe on top of skin before puncture
3. slowly leap frog (let target diasppear, move probe to find it, repeat)
4. Tap, tap, tap gently on side of vessel before insertion

Question 8

What is the seams method

Answer 8

For long axis needle view
There is a market on the side of the probe w/ a line to show where the beam lines up
line needle up w/ seam so it’s in the center of the US beam
make sure plunger of needle lines up w/ distal end of seam too

Question 9

How do you re-find a lost needle tip in short axis?

Answer 9

Place probe distal to needle insertion, slowly bring it back toward the needle while slowly moving needle barely in and out to help with locating it

Question 10

How do you find a lost needle tip in long axis?

Answer 10

Fan to one side to locate needle again
pull needle back and recenter above target

Question 11

How do you correctly ID a vessel?

Answer 11

1. Shape - arteries are more round due to higher pressure, veins tend to be round but can be more oblong
2. Pulsatility - arteries have pulsitile pressure w/ a little external pressure
3. compressibility - veins press flat and arteries do not
4. color doppler - color corresponds to direction of blood flow: red toward probe, blue away - artery will show pulsitile flow, vein more steady and slow
5. pulsed wave doppler - arteries have high phasic flow, veins steady flow velocity

-use multiple methods to confirm identity - want veins!!