GuidewireCentralLine
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. 

Guidewire1

Guidewire2
 
Neither Dr. Hall or I have any financial disclosures with the Arrow company.
 
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