Tuesday, January 10, 2012

Trick of the Trade: A removable guidewire


An essential skill of any innovative troubleshooter in the Emergency Department is the ability to recognize when one piece of equipment may be used elsewhere. For instance, what's your go-to approach when looking for a spare guidewire? Let's say you are trying to salvage an ultrasound-guided basilic vein IV catheterization.

Here's where I go for guidewires:
  • Central line kits
  • Pneumothorax pigtail kits
  • Seldinger-based cricothyrotomy kits
Trick of the Trade:
Seldinger-based Arrow arterial lines

Thanks to Dr. Kennedy Hall (UCSF-SFGH EM resident), he recently discovered that the Seldinger-based arterial lines, made by Arrow, have removable guidewires! If you look closely along the length of the transparent guidewire sheath, there is a narrow slit which allows you to remove the guidewire. The added bonus is that there is a black plastic handle at one end of the guidewire which can protect against losing the guidewire into a catheter.

Whoa, it's like magic.





Neither Dr. Hall or I have any financial disclosures with the Arrow company.
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2 comments:

  1. With the black plastic tip on it though, how are you going to advance anything over the wire?

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  2. Good question. I mainly use it for deep IV's I'm trying to establish but need to troubleshoot. You just need to cannulate the vein with the wire but don't need to actually need to thread entirely through the IV. If you absolutely needed to get rid of the black plastic tip, just cut it off.

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