by Steven E. Zimmet, MD, RVT, FACPh
Catheter Tips and Tricks:
- Keep the patient and room warm to minimize vasospasm. Turn the air conditioning on after your fiber/catheter is properly positioned.
- Perform access with the patient in the reverse Trendelenburg position.
- Use a micropuncture kit (small bore 21 gauge percutaneous needles, 018" guidewire) to access small veins.
- 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.
- Move carefully but quickly once you access the vein. Place your wire and advance the sheath before vasospasm develops.
- 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.