Forum topic

6 posts / 0 new
Last post
nerve bundles
can anybody explain to me how to visualize the nerve bundles using site rite?
Karen Day
Karen Day's picture
I don't use the site rite

I don't use the site rite (we use the sonosite) but the best way I can describe it is it resembles a piece of honeycomb cereal.  It does not compress and sometimes can be moved from side to side when over top of a vessel.  I usually find these located near the brachial veins or artery, but have seen them near the Basilic as well.


Michael Drafz
Michael Drafz Vascular

Michael Drafz

Vascular Access Specialist

Sharp Memorial Hospital San Diego, CA

 You usually run into this with accessing the Brachial veins. Unfortunately you rarely can see the nerves on the Site Rite (it is better with the 5 & 6 versions, below that don't even try to find them). Sometimes they appear as bright white little circles on top of the veins or in between the vein and the artery.

Michael Drafz RN, CRNI, VA-BC

Clinical Lead Vascular Access Service

Sharp Metropolitan Medical Campus

San Diego, CA


Karen Day
Karen Day's picture
I agree, I trialed the site
I agree, I trialed the site rite 6 - was very different from my I-look.  I can easily identify nerve bundles on my sonosite I-look.  I guess it's what you get used to also. 
Usually they are most

Usually they are most commonly found with the Brachial verses the basilic.

Anytime you see a vein that won't squish or you can't smash with pressure and it won't beat back at you like an artery would while applying pressure..... suspect a nerve and don't go through it! Usually it will be pretty small, although I've see fairly large ones sometimes..   

The only other option is a clotted vein but usually if its deep running with the brachial artery, that won't be the case, it will be a nerve.

Trying to see silver linings etc is much more dependent upon the quality of ultrasound and image..... I have never been able to trust such findings... I go more with the above method.




Always remember that you're unique. Just like everyone else.

The second mouse gets the cheese!

Also to add..... please
Also to add..... please always verify the median nerve PRIOR to attempting to canulate the brachial veins.  It is too late when you have already hit it. My expereince in net working with nurses, is that they wonder why the electric shock, stinging, fire is occurring in the hand of the patient.  It is too late at this point.  Identification of this very important structure is imperative prior to cannulation.

Cheryl Kelley RN BSN, VA-BC

Log in or register to post comments