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Flowchart of the Operation Process


Flowchart of the operation process:

1. Use the probe to locate a satisfactory image, and stabilize it by resting on the palm side or the elbow as a fulcrum; (Figure 1)

 

 

2. Set the probe’s preset puncture depth, and align the blue blade‑tip indicator with the probe to ensure optimal imaging quality; (Figure 4)

3. Locate the midline of the probe for needle insertion; a marking technique can be used to identify the midline. (Figure 5)

4. During puncture, do not exert force with the fingers or wrist; instead, use the elbow to drive the forearm, and the forearm to drive the wrist, performing the needle insertion to ensure… When the puncture needle is advanced within the ultrasound beam, applying force with the finger or wrist can cause the needle to follow a curved trajectory, extending beyond the ultrasound beam’s field of view. Figure 6)

5. After advancing the needle a certain distance, return your gaze to the screen to assess the target nerve’s position and the clarity of the needle’s visualization. When performing a midline puncture and the needle’s visualization is unclear, slightly adjust the probe’s position until the distal 1 cm of the needle tip is fully visualized.

6. If, after adjusting the probe, the target nerve remains unclear, it indicates that the puncture trajectory and the clearest image of the target nerve do not lie in the same plane; in this case, withdraw the puncture needle and re‑aim, advancing along the probe’s midline.

7. The reason for poor visualization of the puncture needle is that the needle’s trajectory deviates from the midline or extends entirely beyond the imaging plane. (Figure 7)

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