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Bernadette Luca...
USN and Needle Guides
I was trained with using needle guides and our team of 5 still practices this way. For those of you who also use needle guides do you have any special tips when you have punctured the vein have a great blood return and now need to insert the guide wire. Do you remove probe pulling needle away from guide on probe and gently hold the needle or do you let it "free fall" then insert your wire or do you start inserting the wire and then gently remove probe/guide from needle. I have tried it different ways and have yet to find the bests practice. There are still times I feel that my angle changes and then can't advance guidewire. It would be great to hear what others are doing.
I was given a tip by the
I was given a tip by the Interventional Radiologist here:  once you have accessed the vein with the needle and are ready to advance the wire, rotate the needle 180 degrees so the bevel is now down, gently remove the needle from the guide, then advance the wire.  The bevel down position lets the wire advance more smoothly because it isn't being pushed upwards toward the vein wall.  I have taught this tip to all team members, and it works well.
Nancy Rose RN IV Team VA

Nancy Rose RN IV Team VA Medical Center Wilmington, DE (800) 461-8262 ext 4830

I pass the wire to the end of the needle while the needle guide is still on the probe (to prevent dislodging the needle from the vein.) Then I pull the probe away from the needle and lower the angle of the needle and resume advancing until I am well into the vein.


Interesting about turning the needle to bevel down after entering the vein. I would think the wire would be more likely to hit the vein wall. But if it works well….


Nancy Rose 

I appreciate the I.R. tip, 

I appreciate the I.R. tip,  At our facility we access the vein via needle guide, then gently remove the u.s. probe and lower the needle. then thread the wire.  Hope this helps.


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