Trick of the Trade: Don’t fight the ultrasound cord for peripheral IV access

Jun 03, 22
Trick of the Trade: Don’t fight the ultrasound cord for peripheral IV access

ultrasound POCUS peripheral iv trick

Ultrasound-guided IVs require hand-eye coordination and fine movements of probe in Goldilocks fashion. Apply too much pressure, and the vein in question is compressed. Slide a little to the right, and now it’s out of the window. Something that practitioners don’t think about is the tension from the cord. If left to its own devices, the cord will tug on the probe, making the probe harder to steer and handle, especially for those tiny veins.

Trick of the Trade: Reduce cord tension

Have the patient grasp the cord!

This makes them an active participant. Usually, if they are awake and good-humored, tell them “audience participation is required.” Doing so will give you enough slack to effectively visualize and troubleshoot the ultrasound-guided IV.

ultrasound cord trick POCUS

 

What if the patient is intubated, or altered, doesn’t quite grasp, or can’t handle the situation?

Tape the cord to the gurney side rail. Use a 2×2 gauze as a buffer between the tape and the rail so the tape doesn’t damage the cord itself.

ultrasound cord POCUS tape

 

Want to learn other tricks?

Read other articles in the Tricks of the Trade series.

Author information

Andrew J. Park, MD

Andrew J. Park, MD

Resident
Harvard Affiliated Emergency Medicine Residency
Beth Israel Deaconess Medical Center

The post Trick of the Trade: Don’t fight the ultrasound cord for peripheral IV access appeared first on ALiEM.

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