YouTube: Episure AutoDetect Syringe for Epidurals
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More YouTube instructional video goodness. This time demonstrating a special syringe to aid in identification of the epidural space--the Episure AutoDetect Syringe.
"(A)n automatic Loss of Resistance (LOR) syringe that provides an objective, visual confirmation that the Epidural Space has been identified. Whether you administer epidural anesthesia regularly or infrequently, we are confident that the Episure AutoDetect syringe will give you enhanced control and sensitivity."
Looks like a very nice training tool.
I personally use the Australian Grip. I learned it from an Australian anesthesiologist (hence my naming of it). I place the Tuohy needle in the interspinous ligament and attach a saline-filed glass syringe. I then apply pressure with the palm of my dominant hand to the plunger only, not touching the hub or needle. On entry of the epidural space, pressure on the plunger causes saline to shoot out of the Tuohy needle opening and the needle stops. The one wet tap I've had with this technique has been in a patient who must have had a non-union of the ligamentum flavum.
[Indigo-Orb]
YouTube: Site-Rite Instructional Video
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The AHRQ published Making Health Care Safer: A Critical Analysis of Patient Safety Practices in 2001. Chapter 21 deals with Ultrasound Guidance of Central Vein Catheterization. I thought I'd include a link to a YouTube video that shows how this device is used:
Although the device has advance considerably since then (see below), the images it provides are still pretty much the same.
I will often use the device to locate and mark an internal jugular vein before draping the patient as I find the use of the needle guide extremely cumbersome.
[Site-Rite]
