First I hope that no actual venous puncture was carried out on this model. Totally unethical. Second the use of ultrasound guidance is strongly recommended for central venous cannulation, The axotrack device is superfluous.
As strong an advocate as I am for the use of real-time ultrasound guidance of central access (admittedly more for femoral or IJ than for SC approaches) this whole device strikes me as a solution looking for a problem.
My thought is that any skilled practitioner should be able to place a subclavian line whilst this particular device is still in the early stages of being assembled.
In addition, the steep angle of approach seems to me to increase the probability of difficulty in passing the guide wire.
I am interested in the assertion that having the arm abducted and externally rotated increases the chance of successful SC cannulation.
This being a positioning approach which I have never seen utilized. I will give it a try – though only after looking at the anatomy with US prior to sticking the patient with a needle.
You do not mention whether this is infra or supraclavicular, although by appearances it appears to be infraclavicular. I worry about the excessive overengineering you employ in your device, with each additional step comes an increased risk of a mistake. In addition this is simply not time efficient, a blind subclavian by landmarks can be placed much faster.
![Chronic Pain Attack [Oh my God, babe??] [Public Place] [Let's Get You Home]](https://i.ytimg.com/vi/3UPe96zlzpk/hqdefault_live.jpg "Chronic Pain Attack [Oh my God, babe??] [Public Place] [Let's Get You Home]")
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lots of money for the company and inventor but not necessarily needed for another person who is familiar with the technology.
First I hope that no actual venous puncture was carried out on this model. Totally unethical. Second the use of ultrasound guidance is strongly recommended for central venous cannulation, The axotrack device is superfluous.
As strong an advocate as I am for the use of real-time ultrasound guidance of central access (admittedly more for femoral or IJ than for SC approaches) this whole device strikes me as a solution looking for a problem.
My thought is that any skilled practitioner should be able to place a subclavian line whilst this particular device is still in the early stages of being assembled.
In addition, the steep angle of approach seems to me to increase the probability of difficulty in passing the guide wire.
I am interested in the assertion that having the arm abducted and externally rotated increases the chance of successful SC cannulation.
This being a positioning approach which I have never seen utilized. I will give it a try – though only after looking at the anatomy with US prior to sticking the patient with a needle.
One always learns something.
Thanks
It is very disturbing to see a subclavian cannulation on a human being model without using a strict sterile technique
You do not mention whether this is infra or supraclavicular, although by appearances it appears to be infraclavicular. I worry about the excessive overengineering you employ in your device, with each additional step comes an increased risk of a mistake. In addition this is simply not time efficient, a blind subclavian by landmarks can be placed much faster.