JMO- Tips on US Guided Cannulation

Hi everyone,

I am a new JMO who is really passionate about ultrasound guided cannulation.

I have practised cannulation to the point where I can cannulate about 95 percent of patients without ultrasound. Now I am focusing on ultrasound guided cannulation for the most difficult patients.

The issue I am running into is that I struggle to consistently identify the needle tip. Just yesterday, I only managed to see the needle tip once it had already entered the vessel, I could tell the needle was pushing on top of the vessel.

I have tried fanning the probe to make it orthogonal to the needle, and I have also moved the probe along the length of the needle shaft to try to identify the tip, but I still cannot seem to visualise the shaft at all.

When I practised on the blue phantom during training, it was much easier to find the needle tip, so I am not sure what I am doing differently in real patients.

I would really appreciate any advice on how to improve needle tip visualisation.