Will read later… and comment appropriately
@intensiveperson.bsky.social

In a well drilled resus area / emergency theatre.
There must be IMO, a run through ready to connect, transducer 24/7, so a quick connect will give us a “gold standard” marker of correct location.

Training etc can be a 4 lumen 12Fr CVC
Major haemorrhage SC access should be a <8Fr access.
Like one of these…
Sorry @vygongroup.bsky.social have you got something better ? 😏

www.teleflexvascular.com/products/ca-...

In an intubated ventilated MT patient already with a PTX and they require CV access…
I feel utilising this opportunity to train anaesthetists on LM access is warranted.
The skill we’re learning here is accessing a vein…

Agree regarding FONA - I think we all do a sim each year on DAS scenario / FONA (at least we should, even as a Consutlant)
IMO same approach to MH and Landmark SC.
US SC should be used more in general… then the transition to LM will be easier and slicker.

Landmark SC access in exsanguinating major trauma….
Needs to be “C”’s FONA skill
May never need it in a career, but we SHOULD be able to do it when the time calls!

Well, well….
If you have large bore access sited peripherally and it’s still working… use it, I agree.
But in busy trauma, when there’s lots of people around the “top end” eg getting ready to site a drain
Getting a US in view to site a US guided SC CVC is hard work

I’d welcome that too Pete!

Not disagreeing that US is safer.
But I’ve never worked in a MTC where I can get access with an US to an exsanguinating patient to get a US line in.
I think we should see landmark SC Access as circulation’s FONA in major trauma.

Arterial trauma is a rare, but potentially life-threatening complication of central venous catheter insertion.

In this interrogation of two national databases of incident reports, outcomes included:
• stroke (10%)
• death (4%)

#AnSky #MedSky

https://doi.org/10.1111/anae.16570

May battle commence….
#landmarkSC for the win #majortrauma ❤️

Places left for Leeds Advanced Critical Care Echo Course
8th -10th July 2025
Three days of excellent echo teaching
Endorsed by ESICM & ICS
#FUSICHD #EDEC #ACCE #fTOE #critcareecho
@manoj-w.bsky.social
@drfreeze.bsky.social
@smallzalex.bsky.social
@medicluke.bsky.social
@lukeflower.bsky.social

Waiting for Max Ridley to join in…

Those liver/trauma surgeons in season 2 of the #TheDiplomat …
They know how to do ERAS! 😂😂