Maaaaaaaan you surgical folk are amazing. My son had a central line put in when he was around 7-8mths old. Paediatric surgeons are a special kind of crazy to learn this sort of procedure and think "I'm going to do this but in the smallest most precious of humans". Total respect and awe for the people who enter into this career path, good luck to all the current and future students 😊
There is much to remember here if you do not perform this procedure on regular basis but it goes fairly quickly placing a central line on regular basis. The review was good on complications. There was no f/u on how to correct problems with placement though. Maybe in a future video. Thank you. This has helped me alot.
Thank you dr arzoo , this video was really helpful compared to others I seen, a step by step approach should be the gold standard when teaching medical students and it’s unfortunate that some doctors don’t adapt to that way , the “explain to me like I’m five “ method is the best when teaching clinical skills and for that I applaud to you 👍🏼
I am a 3rd year Internal Medicine resident and I have a couple things to clarify. I am a little confused by the video.... A couple things I notice that are somewhat important from what I know. First, "Dilate the vessel with the scalpel" sounds wrong and maybe needs to be clarified Second, I really don't think you pull out the wire the way that was instructed. I agree with holding the wire at all times. The step that was very important and missed/confusing is introducing the catheter. Hold the wire and retract the wire until you see it at the entrance of the catheter. Hold the wire at the entrance of the catheter and introduce the catheter into the vessel. Keep introducing until the mark that she indicated. Once introduced into the vessel then and only then can you remove the wire. The wire is used to help introduce the catheter into the vessel and needs to be in place when introducing the catheter. From the video it seems as though she is saying hold the wire at the base, once you see the wire at the entrance of the catheter, then pull the wire out; however, I don't believe she mentions when to introduce the catheter itself. Please let me know if others agree with what I am saying. Maybe this is obvious and does not need clarification... Also, I would love to see the introduction when placed on the dummy.
Mam, i think you should include how to differentiate the vessels,carotid and IJV then aspirate the blood,,,,that would be great for learners. Thank you
when you put pressure on a vein it should collapse. When you put pressure on an artery with the ultrasound probe it will pulsate and not collapse the entire time. When putting in central lines, I was taught to do a gravity test with IV tubing. Basically you connect the IV tubing before you dilate and hold it down then up and the blood should go back down the tubing because normally venous pressure is low. The real best way is to connect it to a pressure monitoring system and make sure you get a cvp waveform, not arterial. However, I’ve never actually seen anybody do that.
Don't unfold the glove packet with your hands! The paper folded back onto the gloves and broke its sterility at 1:22. Unfold it after you put on the gown, keep hands inside the cuffs. Hands remain inside cuffs until physically inside glove
@@undearwearman654 I disagree. The sterile field should be kept as sterile as possible. Your bare hands are considered dirty even if you've done a surgical hand scrub.
@@undearwearman654 incorrect. They do usually have a 1-2" margin that you can touch, but the cover shouldn't fold back onto itself once opened. You should also open away from yourself, keep your arms above the waist, avoid working directly over your sterile field, etc. She broke all of these rules in a matter of seconds.
I’ve had 2 central line attempts while I was awake. Though I had many from surgeries. The first one I had they put it in in the ER. I was fully awake. They got it in no problem. The second one was while I was in the ICU. The doctor doing it was awful. It was his first time and I even ask if he should be doing this. There was another person trying to help him but it wasn’t working. It’s interesting to see it from this angle. The one weird thing is when I got my last central line taken out the doctors where making me say "home" and but more like hommmmeee. I can’t remember but they make you do that while taking out the line. The vibration has something to do with it I think.
i believe it is to cut out the background talking so you arent distracted and to only pull focus to the step by step guide. most med students and residents actually do refer to google and youtube from time to time.
I can never place a central line, though i did manage to remove mine, after i was transfered from the icu, to the trauma sector 😁😁😁nurse was shocked and said i need a psychiatrist
In India we don't waste so many things like one knife, needle forceps, many other small items for each procedure, we need only half of these to do the procedure
CHG, please watch the IFU video. The scrub direction is not circular like betadine. It’s in a back and forth friction scrub, hashtag or basketweave. Disinfecting and dry time depends on the body surface and area you’re disinfecting; not all patients dry at the same rate. Must be allowed to completely dry. If used properly, unlike alcohol and betadine (kill time over once dried)… CHG can continue to disinfected for 72-96 hours. Great video though. My comments are with love for you and all of our patients. You are only cleaning the way you were taught. All medical students should be required to read every product instructions for use, especially since infusion therapy and vascular access research and product updates are moving rapidly. We are not in an industry that if all else fails, we’ll read the IFU. Imagine if a patient died from sepsis and you were the inserter… called to reenact your entire procedure, from start to first finish. Protect yourself from legal claims. CLABSIs are our fault many times and deaths related to infections should not be from improper use of a disinfecting agent.
Why the 15th mark? Surely, the depth of the catheter is determined by the distances from the insertion site to the lower 1/3rd of the SVC? Which can be different for each patient.
Every certified Droctor should know how to do this ... don't feel bad it's the same in my country😥 but lots of doctors are working on themselves and trying their best to learn everything they can pick up ... you have to be prepared for the " just in case " situations ... be one of them and i highly advise you to learn every single skill .. good luck
Ur Iranian wow I want to become a cardiac surgeon in the future & I just enjoyed this video so much I wanna keep in touch with you also I'm a Iranian too where r u living Curren answer pls if u like
The most important thing is to get organized before you start. Otherwise it’s going to take you forever and you won’t look like you know what you’re doing. Also 15 cm is only for the right IJ. Other insertion sites require a different depth of insertion.
the chloraprep swab needs to be utilized in a vigorous back and forth motion and left to dry prior to puncturing skin. The method you used for cleaning is for betadine.
I don't understand that comment about the shoes. She made an astonishingly good video about a procedure that she evidently mastered. So what if she likes to wear foxy footwear?
Hello dear I am Mohd Javed (Nurse) Will you tell me where are you from or which country you are working pl......................,..........................................................................................................................................................................................................................😭😭😭🙏🙏😭😭😭
Maaaaaaaan you surgical folk are amazing. My son had a central line put in when he was around 7-8mths old. Paediatric surgeons are a special kind of crazy to learn this sort of procedure and think "I'm going to do this but in the smallest most precious of humans". Total respect and awe for the people who enter into this career path, good luck to all the current and future students 😊
I had to do this today, this guide helped me a lot, my resident was very impressed.
Thank you
I had a central line in ICU. I’m a retired midwife but I needed to see it from this perspective. Thank you.
Hi
She is an amazing doctor and a great teacher too ...may Allah showers his blessings on you madam .
The amazing drs and nurses that were working so hard to save my life are so amazing...I can't believe they did that to me..thank you so much
There is much to remember here if you do not perform this procedure on regular basis but it goes fairly quickly placing a central line on regular basis.
The review was good on complications. There was no f/u on how to correct problems with placement though. Maybe in a future video. Thank you. This has helped me alot.
Hlw maam i am a small village medicine practitioner ,this video is really help full for me 😍 thanks a lot maam
So fascinating, I’m not a medical person at all. But thanks for the great content doc 😊
Good
Pray for me to be a medical student
Thank you dr arzoo , this video was really helpful compared to others I seen, a step by step approach should be the gold standard when teaching medical students and it’s unfortunate that some doctors don’t adapt to that way , the “explain to me like I’m five “ method is the best when teaching clinical skills and for that I applaud to you 👍🏼
As a cath lab technician I was looking for this content
It is looking so cute, but actually it is difficult in real life
Cute ? LOL
Thank you maam..I am watching this video as I am posted in covid ICU and I wanted to learn this procedure..🙏🏼
Thank you for such a nice and simple lesson, I was looking for such easy yet comprehensive video.
I had this done this summer (2021) the doctor who put it in was awesome and I didn't feel a thing.
Nothing comes to your beauty queen
Imagine seeing this on your doc's phone right before he puts one in you
Thank you very much for the video with kindness and respect for excellent explaining and clearfaying
My immediate thought was “how is she wearing heels for her shift!!”
Thanks so much by explain all procedure !!! I think amazing watch here from Brazil .
Great Video...
I so proud of you I am also an Afghan 😇
Excellent. Exudes Confidence. Thank you.
Thanks for the lesson! Will practice on my niece!
😂😂😂
Who needs medical school when I could just watch videos like these?
Awesome tutorial. Thanks so much!!
I am salesman of medical items, this video is helpful for my study
I can do everything only my issue is i cant wear sterile glooves properly🤦🏻🤦🏻
Oh My Allah that creates a fair in my mind Doctor. Good explanation
Beautiful & very helpful lecture today 👍👏👏👍👌👌👌👍👏👌👍👏👌👍👏👌
Beautiful doc
wow that was really helpful , Thanks Doc
I didnt know family doctors need to do central lines , interesting but it is very realistic and useful
Is anyone else noticing breaks in the audio?
Opening up the non-sterile glove packet on the sterile field just made the entire gown and outside of the sterile kit unsterile
It was very good and beneficial guide.
😍so informative mashaallah
I am a 3rd year Internal Medicine resident and I have a couple things to clarify.
I am a little confused by the video.... A couple things I notice that are somewhat important from what I know.
First, "Dilate the vessel with the scalpel" sounds wrong and maybe needs to be clarified
Second, I really don't think you pull out the wire the way that was instructed. I agree with holding the wire at all times. The step that was very important and missed/confusing is introducing the catheter. Hold the wire and retract the wire until you see it at the entrance of the catheter. Hold the wire at the entrance of the catheter and introduce the catheter into the vessel. Keep introducing until the mark that she indicated. Once introduced into the vessel then and only then can you remove the wire. The wire is used to help introduce the catheter into the vessel and needs to be in place when introducing the catheter. From the video it seems as though she is saying hold the wire at the base, once you see the wire at the entrance of the catheter, then pull the wire out; however, I don't believe she mentions when to introduce the catheter itself.
Please let me know if others agree with what I am saying. Maybe this is obvious and does not need clarification...
Also, I would love to see the introduction when placed on the dummy.
thanks drarzoo awsome job
You did a wonderful job explaining! Thank you
Mashaa ALLAH doctor very good explanation
Mam, i think you should include how to differentiate the vessels,carotid and IJV then aspirate the blood,,,,that would be great for learners. Thank you
Yup I was Thinking the Same.
when you put pressure on a vein it should collapse. When you put pressure on an artery with the ultrasound probe it will pulsate and not collapse the entire time. When putting in central lines, I was taught to do a gravity test with IV tubing. Basically you connect the IV tubing before you dilate and hold it down then up and the blood should go back down the tubing because normally venous pressure is low. The real best way is to connect it to a pressure monitoring system and make sure you get a cvp waveform, not arterial. However, I’ve never actually seen anybody do that.
I would be obliged if you share me the name of company which manufactures this CVP kit. It's very compact
Arrow
I am posted in covid 19 icu very helpful
Thanks much! But you forgot to rotate the patient's head to the left!It will be serious mistake!
Thank you ,the vedio was helpful and I wish more vedio about central line training placement for dialysis patients . Thanks Dr. Mohamed rifat
Well explain step-by-step 👍
Very Helpful!!! Excellent Work!
Don't unfold the glove packet with your hands! The paper folded back onto the gloves and broke its sterility at 1:22. Unfold it after you put on the gown, keep hands inside the cuffs. Hands remain inside cuffs until physically inside glove
Those folds are meant to be opened with bare hands
@@undearwearman654 I disagree. The sterile field should be kept as sterile as possible. Your bare hands are considered dirty even if you've done a surgical hand scrub.
@@undearwearman654 incorrect. They do usually have a 1-2" margin that you can touch, but the cover shouldn't fold back onto itself once opened. You should also open away from yourself, keep your arms above the waist, avoid working directly over your sterile field, etc. She broke all of these rules in a matter of seconds.
great job
Very easy way to understand... Thanq
This was very helpful, thank you!
I’ve had 2 central line attempts while I was awake. Though I had many from surgeries. The first one I had they put it in in the ER. I was fully awake. They got it in no problem. The second one was while I was in the ICU. The doctor doing it was awful. It was his first time and I even ask if he should be doing this. There was another person trying to help him but it wasn’t working. It’s interesting to see it from this angle. The one weird thing is when I got my last central line taken out the doctors where making me say "home" and but more like hommmmeee. I can’t remember but they make you do that while taking out the line. The vibration has something to do with it I think.
Interesting. I wonder why they did that.
why sound in and out?
i believe it is to cut out the background talking so you arent distracted and to only pull focus to the step by step guide. most med students and residents actually do refer to google and youtube from time to time.
I can never place a central line, though i did manage to remove mine, after i was transfered from the icu, to the trauma sector 😁😁😁nurse was shocked and said i need a psychiatrist
Thanks really
Dang the Dr walked up to the camera and I forgot what the video was about!
Thank you Dr.
Excellent 🤝
Can you upload the video of same procedure done on a live human subject?
In India we don't waste so many things like one knife, needle forceps, many other small items for each procedure, we need only half of these to do the procedure
Yeah unfortunately, sometimes things can be wasted, we don't always use all of the items included in the kit
CHG, please watch the IFU video. The scrub direction is not circular like betadine. It’s in a back and forth friction scrub, hashtag or basketweave. Disinfecting and dry time depends on the body surface and area you’re disinfecting; not all patients dry at the same rate. Must be allowed to completely dry. If used properly, unlike alcohol and betadine (kill time over once dried)… CHG can continue to disinfected for 72-96 hours. Great video though. My comments are with love for you and all of our patients. You are only cleaning the way you were taught. All medical students should be required to read every product instructions for use, especially since infusion therapy and vascular access research and product updates are moving rapidly. We are not in an industry that if all else fails, we’ll read the IFU. Imagine if a patient died from sepsis and you were the inserter… called to reenact your entire procedure, from start to first finish. Protect yourself from legal claims. CLABSIs are our fault many times and deaths related to infections should not be from improper use of a disinfecting agent.
Great work ma'am
Thanks for sharing
Subscribed :)
Nice
How long does this procedure take
So helpful!
Thats scary. Is the patient aware of what's happening when this procedure is carried out?
Great 👍
Why the 15th mark? Surely, the depth of the catheter is determined by the distances from the insertion site to the lower 1/3rd of the SVC? Which can be different for each patient.
Im a bit shocked that a family physisian performs this procedure. In my country only aneshtesiologists do it 😦
Physician assistants also do it in America
In Thailand , the resident in training also do this procedure!!
ruclips.net/video/aRO1AOmuCh0/видео.html💥💥
Every certified Droctor should know how to do this ... don't feel bad it's the same in my country😥 but lots of doctors are working on themselves and trying their best to learn everything they can pick up ... you have to be prepared for the " just in case " situations ... be one of them and i highly advise you to learn every single skill .. good luck
@@tonnamlumtan1622 in India even interns can try it.
Ur Iranian wow I want to become a cardiac surgeon in the future & I just enjoyed this video so much I wanna keep in touch with you also I'm a Iranian too where r u living Curren answer pls if u like
I am Afghan. That is great! Best of luck
The most important thing is to get organized before you start. Otherwise it’s going to take you forever and you won’t look like you know what you’re doing. Also 15 cm is only for the right IJ. Other insertion sites require a different depth of insertion.
I like this video but, the tray wasn't sterile. you made a few mistakes.
Great work!
Thanx for the vid .. whats your specialty doc
Orthopedic
Family Medicine
are u the doctor or the treatment !!
Great❤
Thanks A Lot So so Vere Much Madam
Thank you
the chloraprep swab needs to be utilized in a vigorous back and forth motion and left to dry prior to puncturing skin. The method you used for cleaning is for betadine.
He specializes in anesthesia, am I wrong?
Thank you! can u please explain why you swapped needles for the lido syringe?
Red needles are usually filter needles, to remove any potential debris before injection
You never inject a patient with the same needle you draw up medication. To prevent infections
I don't understand that comment about the shoes. She made an astonishingly good video about a procedure that she evidently mastered. So what if she likes to wear foxy footwear?
I'm without central lines...
Too bad about all the chatter in the background, was there no where quiet to do the video?
What is stopping you from acting in Hollywood
Ms sadiqi arent you from Iran?
Superb ❤️
Wow, I know where I want to place my central line lol
Mam ,you're how much heparin used ??
can that patient breath?
Explanation is fantastic but when doing practical it's not good
It was helpful ☺️😄
You is dokter or Doktor?
why does the audio keep cutting out
Why does the sound keep cutting in and out?
Is there will be tachy while inserting
Se deberían fijar los también los puertos para sutura del catéter ya que con este método tan solo tirar puede hacer que se auto retire el mismo
Sterility was broken when the sleeve of the gown dropped below the sterile field
Missing sounds 😢in between doc ,reload,use good mic
Hello dear I am Mohd Javed (Nurse) Will you tell me where are you from or which country you are working pl......................,..........................................................................................................................................................................................................................😭😭😭🙏🙏😭😭😭