Luke McMenamin
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medicluke.bsky.social
Luke McMenamin
@medicluke.bsky.social
Anaesthetist
#Trauma #HPB #Transplant - in no particular order
Personal Views
Leeds Via Northern Ireland
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.
September 4, 2025 at 8:40 AM
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-...
CA-11142 - Teleflex Incorporated - Vascular Access Product Catalog
www.teleflexvascular.com
September 4, 2025 at 8:38 AM
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…
September 4, 2025 at 8:32 AM
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.
September 4, 2025 at 8:29 AM
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!
September 4, 2025 at 8:13 AM
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
September 4, 2025 at 8:11 AM
I’d welcome that too Pete!
February 21, 2025 at 7:05 PM
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.
February 21, 2025 at 7:03 PM
May battle commence….
#landmarkSC for the win #majortrauma ❤️
February 21, 2025 at 3:22 PM