Draw as you push, down
toward the clavicle– NO
NO, STOP. Down! Toward
the clavicle, the boundary there
is hard, the vessel is soft,
the return is bright, pink, rewarding
with a gush. That’s not a subclavian
anything! Ease it in… no, down!
Suck as you advance, draw in until
you reach that sweet gushing pink
moment, there! Now remove the bulb,
keep it stiff! Let the needle sit, no!
That’s the damn Niagra Falls coming
out like a honeymoon: plug it! No!
With the dilator, advance the dilator!
There… softly, tease it apart, no…
that’s fine, that’s just enough blood
as I’d expect for a first time, no need
to worry if you keep the pace, good.
Dilate. Tease it apart, yes, gently,
gently…. Insert the guide wire.
Hold the catheter in your right hand,
hold the guide wire in your right hand,
hold the neck with your wrong hand,
I meant the left, it was a joke. NO!
Hold the catheter! Use the same hand
to draw it in, advance the wire. Keep it
in place, continue advancing the wire…
is it moving? NO. You need to move
in, out, down,
advance the wire. There. Good, now
feel the site, don’t puncture the vessel!
Good… Leave it there, hold the catheter.
With your wrong hand, NO! Keep it sterile!
Reglove. You have botched the whole thing
with the disgusting rotating nurse, remember
that you wouldn’t touch her with a 10-foot pole!
Now… push it in. Good, feel it slide in, right?
That’s how you know it’s good, nice and patent.