Dear Sirs,

First, thank you for putting all the tools I need into one sterile package, minimizing the amount of running around finding little pieces to start central lines on my patients. (A central line goes into the central venous circulation, allowing the use of hypertonic medications and monitoring of venous pressures to guide fluid resuscitation.)

Now, to my gripe: apparently none of you have thought about the order in which these devices are used when starting a line.

Yes, everything has a special place, but it tells me you haven’t thought out the actual use of the kit when I have to dig the Seldinger wire out of the bottom of the kit despite its use being necessary very early in the process, and getting it out dislodges many of the other items from their pockets, then making the whole shebang a mess.

Therefore, I offer my assistance in designing a kit that makes more sense when it’s used.

Respectfully,
GruntDoc

FYI, here’s a link to a nicely done animation of how to place a central line: (www.youtube.com/watch?feature=player_embedded&v=QHiuYc22pfE). I do mine a little differently (direct sonographic guidance usually), but this is good for the gist. (The wire is there, but it’s really hard to see…).

Read Dr. Roberts’ blog at www.gruntdoc.com.