by Steven E. Zimmet, MD, RVT, FACPh

Catheter Tips and Tricks:

1. Keep the patient and room warm to minimize vasospasm. Turn the air conditioning on after your fiber/catheter is properly positioned.
2. Perform access with the patient in the reverse Trendelenburg position.
3. Use a micropuncture kit (small bore 21 gauge percutaneous needles, 018" guidewire) to access small veins.
4. Sometimes your needle may be in the vein, but there is no blood return visualized. Attach a syringe and gently aspirate. Proceed if you can aspirate and confirm you are in the correct vein. Re-attempt access if there is no return.
5. Move carefully but quickly once you access the vein. Place your wire and advance the sheath before vasospasm develops.
6. If you experience difficulty advancing the sheath because of vasospasm, inject some of the flush solution through the catheter while attempting to gently advance the sheath.