they didnt knumb mine it hurt so bad i was crying and she had problems huge bruise across my whole wrist its been a year and i still remember what it felt like and area still senstive .
I’m so sorry to hear that. It certainly can bruise quite badly, much worse than puncturing a vein as it’s under much greater pressure in the artery. It’s true not everyone numbs the skin and I wasn’t taught that way but it’s a sensitive part of the body so I like to make it nice and numb for my patients.
Hi! Thanks for the comment. Indeed it was only a few mm deep though it of course varies with body habitus. Average depth is approximately 2.5 mm in adults so with angling the needle it only need to be inserted a few mm more than that. In patients with thicker arms it can approach 10 mm or more, and with cachexia it can be completely visible pulsating in the wrist. All easily checked with a quick ultrasound scan where available.
Hi @xhisatank. Thanks for the comment. As I said in the video it's optional. If you never use it then I suggest carrying on that way. I don't use it either but this video is targeted at med students soon to be interns and if they're about to dive about in someones wrist and not get the sample on first stab then I think it's in the patient's best interest to have anaesthesia first. Sure it's a second stab of a needle and a sting of some lignocaine but that's preferable to the multiple approaches I sometimes see from people in the learning phase. It's a painful procedure for many people and patient comfort is highly important to me. So some local is very reasonable in some scenarios.
Hi Dylan. I didn’t mean to imply the full 5 ml is required. 5 ml is just the smallest vial of lidocaine we have in our institute. Of course very little is required for the small area above the artery or sometimes none at all for a very obvious artery. Thanks for your comment.
Thanks for the comment. No I never perform it nor do any of my intensivist or anaesthesiologist colleagues . It has repeatedly been shown to have very large inter-observer variability and very poor sensitivity (though higher specificity). Overall it’s diagnostic validity is poor and is not a good predictor of hand ischaemia and so should not be performed.
@@ItsJustAPlug Yea we are too and I know lots of the cardiothoracic surgeons still check it if they're planning to harvest the radial for bypass. But alas the evidence for it isn't there! It's a perfect little test for an OSCE as it's so quick and easy. I still teach it to the students but warn them that it isn't a perfect test.
It would be frowned upon in the medical school to cannulate the arteries of our interns 😂 I hope to organise consent from a patient having one done someday once ethical approval and paperwork etc is in order.
they didnt knumb mine it hurt so bad i was crying and she had problems huge bruise across my whole wrist its been a year and i still remember what it felt like and area still senstive .
I’m so sorry to hear that. It certainly can bruise quite badly, much worse than puncturing a vein as it’s under much greater pressure in the artery. It’s true not everyone numbs the skin and I wasn’t taught that way but it’s a sensitive part of the body so I like to make it nice and numb for my patients.
Thanks for sharing this video 😊😊👏
Thank you for watching. I hope it was of some help.
Mine hurt so bad I will NEVER allow it to be done again, they would have to knock me out first.
If that patients' radial artery is only a "couple of mm under the skin", God help them😅.
Hi! Thanks for the comment. Indeed it was only a few mm deep though it of course varies with body habitus. Average depth is approximately 2.5 mm in adults so with angling the needle it only need to be inserted a few mm more than that. In patients with thicker arms it can approach 10 mm or more, and with cachexia it can be completely visible pulsating in the wrist. All easily checked with a quick ultrasound scan where available.
Hello. I looked for the information about the depth of the artery in many places. Can you recommend me a source to check this information?
@@doctoraoifebee.
Thank you
Does it hurt 😂 ? Or feel like a regular blood draw or iv ?
It is painful cause of the pressure in the artery - it's not a normal blood draw. It's done after anaesthesia in the area.
@@Reticence9zen924 can you scale it from 1-10 ?? The pain level ?
@@wckdaintgood Never had it so can't comment.
It hurts and my pain tolerance sucks so around a 5 or 7 for me which depends on the site (radial: 7, brachial: 5).
In my case, it felt like they were sticking it through my wrist.
I have NEVER used anesthetics in 30 years of ICU nursing...
Hi @xhisatank. Thanks for the comment. As I said in the video it's optional. If you never use it then I suggest carrying on that way. I don't use it either but this video is targeted at med students soon to be interns and if they're about to dive about in someones wrist and not get the sample on first stab then I think it's in the patient's best interest to have anaesthesia first. Sure it's a second stab of a needle and a sting of some lignocaine but that's preferable to the multiple approaches I sometimes see from people in the learning phase. It's a painful procedure for many people and patient comfort is highly important to me. So some local is very reasonable in some scenarios.
We do it without anesthesia
We do in the patient under GA but usually use local otherwise.
Language isdues😊😊
a full 5cc syringe of local? you really only need about half a CC of lidocaine to produce a decent sized skin wheel
Hi Dylan. I didn’t mean to imply the full 5 ml is required. 5 ml is just the smallest vial of lidocaine we have in our institute. Of course very little is required for the small area above the artery or sometimes none at all for a very obvious artery. Thanks for your comment.
So no modified Allen’s test?! Okayyy
Thanks for the comment. No I never perform it nor do any of my intensivist or anaesthesiologist colleagues . It has repeatedly been shown to have very large inter-observer variability and very poor sensitivity (though higher specificity). Overall it’s diagnostic validity is poor and is not a good predictor of hand ischaemia and so should not be performed.
@@doctoraoifebeeReally? We are still taught to do it at med school and for our OSCEs.
@@ItsJustAPlug Yea we are too and I know lots of the cardiothoracic surgeons still check it if they're planning to harvest the radial for bypass. But alas the evidence for it isn't there! It's a perfect little test for an OSCE as it's so quick and easy. I still teach it to the students but warn them that it isn't a perfect test.
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So no explanation here, no artery zzz
It would be frowned upon in the medical school to cannulate the arteries of our interns 😂 I hope to organise consent from a patient having one done someday once ethical approval and paperwork etc is in order.
Hey dont we need to carry abg syringes in ice bod to prevent errors jn readinh?