Wednesday, March 19, 2008

Bevel Up or Bevel Down?

During the ultrasound teaching session, the advice given by one of the USC anesthesia folks was "Why keep the bevel up on any finder needle? Keep it face down". The needle tip is sharp all around, so there shouldn't be any problems in entering tissues. His theory (which makes sense): if the bevel is down, when you see blood return then the whole needle lumen is inside the vessel which greatly aids wire placement in the Seldinger technique; therefore, wire invasion into the vessel wall or outside of the vessel is less likely to occur. Has anyone else heard of this technique?

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