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Left Sided IJ's

Discussion in 'Anesthesiology' started by HalO'Thane, Apr 18, 2007.

  1. HalO'Thane

    HalO'Thane New Member

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    If I am right-handed and need to perform a Left IJ for whatever given indication, which hand do I use to control the needle? It seems I would still have better fine motor control with my right hand (i.e. dominant hand). However, it would seem pretty damn akward to criss-cross my arms by palpating the carotid and retracting excess skin with my left hand and aspirating venous blood with my right. Just hoping for some input before ever actually being faced with this scanario.
     
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  3. VolatileAgent

    VolatileAgent Livin' the dream

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    it's not too much harder, actually. you don't have to switch hands either, it's just that the head is more "in the way" and you have to resist the urge to aim towards the wrong nipple.

    personally, if i'm doing a subclavian, i almost always pick the left side first. this requires you to "cross palpate" the clavicle with your left hand over your hand with the needle, but this doesn't seem that awkward. you have a much better chance of threading whatever catheter you're putting in caudad toward the RA from the left.

    are you guys following line-infection reduction initiatives at your institutions?

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5440a2.htm
     
  4. militarymd

    militarymd SDN Angel

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    Try practicing using your left hand....after 5 or so, you won't know the difference.
     
  5. VolatileAgent

    VolatileAgent Livin' the dream

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    honestly, i've done probably less than ten left-sided IJ's. i'll give it a try.
     
  6. rn29306

    rn29306 Drugs are bad, m'kay?

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    Very subtle mil.....but pretty funny. :laugh:
     
  7. VolatileAgent

    VolatileAgent Livin' the dream

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    :confused:

    where's your mind? ;)
     
  8. militarymd

    militarymd SDN Angel

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    I'm with volatie here...I'm serious....this time.
     
  9. rn29306

    rn29306 Drugs are bad, m'kay?

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    Mil that had to be the most blatant doublespeak I've ever seen on here and I can't believe I'm the only one that said something. But if you say so....

    But damn...I gotta go play the lottery or something....Mil and VA agree on something. :confused:
     
  10. burntcrispy

    burntcrispy Member

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    Good one Mil. I didn't catch it at first.

    For me it was just easier to learn the left sided IJs left handed. I put in my left sided a-lines left handed also. And, on occasion I'll throw in an IV left handed to change things up a bit :).
     
  11. jetproppilot

    jetproppilot Turboprop Driver

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    Speaking of left handed stuff.....Started playing around with a ball & bat with my four year old about six months ago...he's right handed and he picked up the bat....left handed!!! Don't know where or why, but man, he sure can whack the ball!

    Hey Noy, think he's headed for the big leagues???
     
  12. UTSouthwestern

    UTSouthwestern 1K Member
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    Where the freak have you been?

    I want my five year old to play baseball, but he wants to whack tennis balls.
     
  13. jetproppilot

    jetproppilot Turboprop Driver

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    Fell off the planet for half-a-year, UT.

    Tennis, huh? Probably better!
     
  14. militarymd

    militarymd SDN Angel

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    Play ball?...my 9 nine year old only wants to play video games.
     
  15. UTSouthwestern

    UTSouthwestern 1K Member
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    There's a reason I refuse to buy video games for my kids aside from Wie Sports.

    Jet, where did you land? LSU?
     
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  17. Noyac

    Noyac ASA Member
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    Make him a switch hitting catcher, Jet. That's the fastest way to the SHOW.
     
  18. jetproppilot

    jetproppilot Turboprop Driver

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    Nope.

    Neighboring new orleans hospital.
     
  19. jetproppilot

    jetproppilot Turboprop Driver

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    I'm on it!
     
  20. VentdependenT

    VentdependenT You didnt build thaT
    Physician Moderator Emeritus

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    15 cm on the right for the IJ (secured to skin)

    19 cm on the left? I've only put in 2 on the left and they were tough because the R side was a scar field.
     
  21. johankriek

    johankriek Banned
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    i tend to avoid the left sided IJ.

    thoracic duct loops around in that area. if you in advertently hit it you can get a chylo thorax..
     

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