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Did you know that a medical guidewire consists of a flexible central “ribbon wire” externally wrapped with a coil-spring wire?

J-shaped guidewires are commonly used in many medical procedures, such as central lines, arterial lines, and pigtails for pneumothoraces. Knowing more about the guidewire makes it possible to carry out a unique Trick of the Trade. For example, let’s say that the plastic introducer is missing or unusable. Using one hand to stabilize the needle in the patient, how do you use your other hand to re-insert a curved guidewire tip into the hub of a needle?

Trick of the Trade

The J-tip of the internal ribbon wire will straighten out if you increase the external coil density in this area. To accomplish this, stretch the wire just proximal to the J-tip. When you stop stretching the guidewire, the J-tip will magically return. I actually got a little gasp of delight from an Anesthesia intern the other day who couldn’t believe her eyes.

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See this guidewire trick in action!

Thanks to Lourdes Adame (Visual Aid Project team member) who helped film this quick iPhone video, when I got a free moment between seeing patients.

Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD

@M_Lin

Professor of Emerg Med at UCSF-Zuckerberg San Francisco General. Founder of ALiEM @aliemteam #PostitPearls https://t.co/7v7cgJqNEn
Michelle Lin, MD