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Indeed, checking blood return is an essential procedure in CV line placement. But, putting too much priority on flashback can hamper efforts to visualize the needle tip on US screen. For a deeper insight into this topic, please go to https://doi.org/10.1186/s41100-016-00... and view my article: “Ultrasound-guided cannulation of hemodialysis access”. A nephrologist in Kyoto, Tadashi Kamata, MD Video Index: Click on the blue type below to jump to a specific stage of the video. 00:00 Start 1. 00:16 Background 2. 01:10 Transverse vs. longitudinal 3. 01:32 Probe holding 4. 02:31 Needle holding 5. 02:54 Determination of puncture site 6. 04:20 In the soft tissue 7. 07:09 Push & stick 8. 09:33 Needle blinking 9. 11:36 Guidewire identification 10. 12:30 Actual case 11. 17:20 Difficult cases 12. 20:26 Troubleshooting 13. 21:30 Needle 14. 22:49 Guidewire 15. 23:05 Ultrasound machine 16. 23:40 Simulation training 17. 24:00 Video recording ************** Relevant papers & videos ************** Three tips for improving the ultrasound visibility of the needle tip. • Three tips for improving the ultrasound vi... Thomas S, et al. “The vanishing target sign: confirmation of intraluminal needle position for ultrasound guided vascular access.” Acad Emerg Med. 2013 Oct;20(10):e17-8. https://onlinelibrary.wiley.com/doi/e... Bondestam S. “The needle tip echo.” J Ultrasound Med. 1992;11:253-6 Kamata T, et al.“Ultrasound-guided cannulation of hemodialysis access. Ren Replace Ther” 2016; 2:7 https://doi.org/10.1186/s41100-016-00... Kamata T, et al. “Visibility of guidewires in ultrasound-guided internal jugular double lumen catheterization” J Jpn Soc Dial Ther. 2012;45:475–82 (in Japanese). https://www.jstage.jst.go.jp/article/... Ultrasound Guided Internal Jugular Vein Cannulation NEJM • Ultrasound Guided Internal Jugular Vein Ca... Rapid IJ (aka Easy Internal Jugular Cannulation) • Rapid IJ (aka Easy Internal Jugular Cannul... Internal jugular central line insertion • Internal jugular central line insertion Ultrasound-guided internal jugular cannulation (short-axis approach) • Ultrasound-guided internal jugular cannula... Ultrasound Guided Subclavian Central Lines -- BAVLS • Ultrasound Guided Subclavian Central Lines... Ultrasound guided peripheral venous cannulation in an actual patient • Ultrasound guided peripheral venous cannul...