I want to bring up and discuss the incredibly annoying moment, when you get a beautiful flashback, hold the introducer needle as steady as a rock, slowly pass the guidewire in, and with a great sigh of exasparation you are met with solid resistance.
Today, whilst inserting an arterial line despite getting a wonderfully free flowing pulastion of arterial blood all over the floor, the guidewire just would not go in, no matter how hard I negotiated. I tried in multiple locations including brachial and femoral, and was met with the exact same fate. An ultrasound also clearly showed the needle tip right in the middle of the vessel, not brushing against the wall/at a tortous part of the artery. After conceding and getting the boss to give it a go, they too had the exact same issue, despite trying both brachials, and femorals.
I have asked quite a few colleagues and seniors, and nobody seems to be able to give an adequete explanation. Possibilities are increased calcification/atherosclerosis of the vessel, or even blaming the cheap guidewires that our department use. Searching online hasn't given me much insight either.
I am determined to know why this phenomena occurs. What are your explanations/ideas/theories?
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