Hello all! Not another rant today. For the last few weeks, I have had the privilege of working with some newbies (don’tcha love ‘em!) So today, we’re looking at some tricks of the trade. After 30 years (or so), I think I’ve gathered a few. Here we go…
Scrub:
1. All sharps are on the table to stick you. Develop good habits in sharps management. There is no reason to suffer an exposure by needle or scalpel.

2. It’s easier to squirt flush out of a syringe than to add more. For venous access, 2 – 4 ml. For flush, 7 – 8.

3. For every access needle, there must be a wire.

4. For every sheath, there must be a flush.

5. Pull up 5 – 7 ml of contrast while you clear the manifold. Use that contrast for your inflator. 5 ml contrast + 15 ml flush for peripheral; 7 & 7 for cardiac.

6. Run the flush from the pressure bag through the manifold, clearing as much air and as many bubbles as possible. Then, turn the handle to run the flush through the pressure transducer. Tap the manifold connection first. This will push bubbles forward. Tap the transducer to move the bubbles out.

7. When clearing lines, spend the most time on the connections. That’s where the bubbles will hide.

8. Make a habit of wet-to-wet connections; flush forward on the syringe and bleed back on the catheter. Wet-to-wet connections will decrease the possibility of bubbles.

9. Always hold the back end of a catheter or long sheath. Controlling the back end means no incidental contamination of a catheter, wire, sheath, balloon or sheath. I usually place the end between my 4th and 5th fingers.

These are just a few I can think of right now. Leave any of your favorite tricks in the comments section. I’d love to hear them!