how to get steady hands?

[stifler]

im currently trying to perform arterial cannulation on a mouse. i can get it in sometimes but my hands are way to unstable to hold it there. i need to keep it there long enough to ligate it. so any tips? wtf is wrong with me? i tried listening to music and using minimum amounts of muscle on my hands. any tips?

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[Winged Scapula]

EVERYONE has a tremor and I imagine most would have difficulty cannulating an artery in a mouse, assuming they are smaller than those in our NICU babies which we find difficult.

The trick/solution is that you must rest your hand on something while doing the procedure. Having your hand resting in mid-air is a sure-fire set-up for tremor and difficulty in keeping things steady enough to do that fine work. Use your instruments to their maximal effect. If you cannot thread the catheter with your hands, use a set of Jake's or Jeweler's forceps to hold the catheter while you cannulate. An A-line wire will give the catheter enough stiffness to allow for easier cannulation (if you are threading without a wire). If you have access to loupes or a magnifying lamp, that would help visualize the artery better as well.

best of luck...

 

[Docgeorge]

"The art of Surgical Technique" by Edgardon (sp??) shows you how to get maximal use out of your instraments also gives you tips for bracing your arms and hand. Tried the techniques in research lab works rather well.

 

[Retinamark]

Tremor can be a problem for some people in ophthalmology, because all movements are magnified under the microscope. The key, as well described above, is to find somewhere comfortable to rest your hand. The more joints you have that are not fixed, the greater the potential for tremor. The ideal is to have your shoulders & elbows fixed to your sides & your wrist fixed by resting on something, so only your fingers do the moving. Tremor is almost never a problem under these circumstances, even under the microscope.
Stating the obvious, but don't forget caffeine increases tremor.
Also relax! Catecholamines always increase tremor.
Don't do heavy workouts before work - heavy weight sessions will also increase tremor, so do them on another day of the week.
If all else fails, keep a hipflask of whisky in your pocket. (only joking)(in case there is any doubt)

 

[Aloha Kid]

The way I see it, the problem isn't the tremor. We all have a tremor. I think what matters is the experience and comfort level one has in doing a procedure. THe tremor is still there, but your nerves which would make you keenly aware of every jostle of finger and hand is not.

 

[stifler]

okay the hands on side technique works, but it puts my body in a weird position. i think i got the procedure down. however, now i am doing middle cerebral artery occlusion and it keeps on going to the wrong artery branches. pisses the crap out of me. i dont think this one has anything to do with my hands.

any tips for this one guys?

 

[NSGYResident]

advance the catheter with a soft wire with a flexible tip. youcan then spin the wire and the tip will select out the vessels you want as you advance it. Are you doing this under fluroscopy?.

Try taking a beta-blocker. Avoid caffeine. Rest your hands on something.

 

[Docgeorge]

Avoid Caffeine?

How dare you sir! That statement is tantamount to sacrilege.