I spoke with a Sonographer friend today about this. He wsa asking me all kinds of questions ...ie...What was the gain set at? Perhaps you just needed to make some adjustments. He did verify that even miniscule air bubbles will make white outs, but that it should dissipate eventually. When they do certain studies they use NS flush to create a contrast in veins/arteries...it appears in vessels as white sparkles, or like Champagne bubbles (for the partiers in the group!)..lol
One other thought....When I picc on people, I use Lidocaine twice. First as a small bleb for the initial MST needle; secondly just prior to the skin nick and insertion of the dilator/sheath, but at a deeper depth. At that point any bubbles present are not an issue as I am already in the vein.
-------------- Original message --------------
From: "Nancy Moureau" <[EMAIL PROTECTED]>
> Even a very small amount of air will reflect the sound waves and show as
> white. Do not misunderstand, it is not a large amount of air, only lidocaine
> bubbles. I was not implying that Jonathon did anything wrong, you just have
> to take the time to flick out the bubbles before injection.
>
> Nancy Moureau, BSN, CRNI
> PICC Excellence, Inc.
> 888-714-1951
> www.piccexcellence.com
> [EMAIL PROTECTED]
>
>
>
> -----Original Message-----
> From: Tim Talbert [mailto:[EMAIL PROTECTED]
> Sent: Monday, April 24, 2006 11:28 AM
> To: Jonathan Rolt; [EMAIL PROTECTED]; nancy
> Subject: Re: lidocaine
>
>
>
> Surely no one would inject enough air to "white out the screnn". Do you
> mean that you think the lido constricts the vessel enough that you cannot
> see it?
>
> The lido works pretty much immediately for most people. Occasionally people
> seem to need more time or more volume.
>
> Tim
>
> >>> "nancy" <[EMAIL PROTECTED]>4/23/06 >>>
> The white out is due to air, not lidocaine. Just get all the air out of the
> syringe before starting and that should not happen.
>
> Nancy Moureau, BSN, CRNI
> PICC Excellence, Inc
> [EMAIL PROTECTED]
> 1-888-714-1951
>
>
>
> ---------- Original Message ----------------------------------
> From: "Jonathan Rolt" <[EMAIL PROTECTED]>
> Date: Sun, 23 Apr 2006 13:18:36 -0400
>
> >
> >Does anyone know how long injected lidocaine takes to absorb? I have
> a few
> >pts that require lido almost all the way down to the vein before thet
> can
> >tolerate the procedure, but then I get a white out on the screen of
> the
> >ultrasound. I seen the IR doc do it before and have no problems? Do
> you
> >then have to move up the vein until you can see again and just make a
> longer
> >angle through the spot? Or is there a time frame, after so many
> minutes the
> >view comes back? We end up sending some of them down to the OR and
> they end
> >up with a surgical central line which could be prevented if I can
> figure
> >this out. Also does any one have the OR put in lines under
> >sedation/conscious sedation I would like to be able to look into that
> . Have
> >the MD order/do the sedation but still go with a PICC whether its
> done by
> >us or not.
> >
> >
> ; >
> >
>
>
>
>
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>
>
>
>
>
>
