About Andrew J. Park, MD

Harvard Affiliated Emergency Medicine Residency
Beth Israel Deaconess Medical Center

Trick of the Trade: Getting the last bit of ultrasound gel from the bottle

It’s a busy shift and you need to perform a bedside ultrasound on a patient’s belly to rule out cholecystitis, when you realize that the ultrasound gel bottle is nearly empty. No matter how many times you vigorously shake the bottle, it’s impossible to get the viscous gel out. In a pinch, you could use hand sanitizer, sterile lubricant, or even water as a substitute for gel. Or you could run to the storage room on the other side of the busy department to grab a new bottle. Or…

Trick of the Trade

Use centrifugal force to move the gel to the top of the bottle!

trick ultrasound bottle gel out

  • Turn the bottle upside down so the cap is facing the ground.
  • Place the bottle into a (fresh) patient’s sock or transducer cover. Alternatively, you can use a plastic bag or ortho tubular stockinette.
  • Firmly holding the bag, and spin the bag for a few seconds in a circular motion, almost like you were throwing a grappling hook.
  • The centrifugal motion will generate an outward force pushing all of the viscous gel to the bottle cap!
  • Once you’ve used the gel, store the bottle cap-side down so you don’t have to do this again.

This trick is useful in a pinch, because it makes use of the entire gel bottle and promotes an eco-friendly use of ED resources.

Tip: Just don’t let go while you swing, lest you turn that patient with the belly pain into a trauma activation from a bottle to the face.

Interest in other tricks?

Read more articles in the Tricks of the Trade series.

By |2022-07-25T11:26:09-07:00Jul 27, 2022|Tricks of the Trade, Ultrasound|

Trick of the Trade: Don’t fight the ultrasound cord for peripheral IV access

ultrasound POCUS peripheral iv trick

Ultrasound-guided IVs require hand-eye coordination and fine movements of probe in Goldilocks fashion. Apply too much pressure, and the vein in question is compressed. Slide a little to the right, and now it’s out of the window. Something that practitioners don’t think about is the tension from the cord. If left to its own devices, the cord will tug on the probe, making the probe harder to steer and handle, especially for those tiny veins.

Trick of the Trade: Reduce cord tension

Have the patient grasp the cord!

This makes them an active participant. Usually, if they are awake and good-humored, tell them “audience participation is required.” Doing so will give you enough slack to effectively visualize and troubleshoot the ultrasound-guided IV.

ultrasound cord trick POCUS


What if the patient is intubated, or altered, doesn’t quite grasp, or can’t handle the situation?

Tape the cord to the gurney side rail. Use a 2×2 gauze as a buffer between the tape and the rail so the tape doesn’t damage the cord itself.

ultrasound cord POCUS tape


Want to learn other tricks?

Read other articles in the Tricks of the Trade series.

By |2022-05-31T00:37:48-07:00Jun 3, 2022|Tricks of the Trade, Ultrasound|
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