Transradial Access - Video 5.1 скачать в хорошем качестве

Transradial Access - Video 5.1

Video 5.1 Note the low angle of insertion and the bounce of the needle as it advances slowly toward the artery using gentle palpation of the artery with the tips of the first two fingers of the left hand. The needle should be bouncing up and down and not side to side. As you get closer to the artery, the bounce increases. If you press too hard with your left hand, you may obliterate the bounce. Apply just enough pressure to trap the needle between your fingertips and the artery. The flow may be pulsatile, but in many cases the flow may be slow. The bright red color of the blood will assure you that the artery has been entered. The wire should advance easily and without any pain. If there is any pain, it is likely that the wire is subintimal and should be withdrawn with the flow rechecked. If there is resistance to advancement of the wire, it is either subintimal or in a side branch. In this case, you can see that the wire can be torqued and advanced but then meets resistance. Finally, the wire should pass the side branch and advance easily. The needle is withdrawn, and a small nick in the skin is made with a #11 blade. (Some catheter and dilators do not require a dermatotomy with a #11 blade.) Once the sheath has been inserted, medications can be administered prophylactically to prevent spasm.