<p begin="00:00:00.419" end="00:00:03.836" style="s2">(light percussion music)</p>
<p begin="00:00:05.024" end="00:00:06.632" style="s2">- [Voiceover] When<br />performing a deep nerve block</p>
<p begin="00:00:06.632" end="00:00:09.653" style="s2">at a steep angle of approach<br />with ultrasound guidance</p>
<p begin="00:00:09.653" end="00:00:12.592" style="s2">seeing the needle in the<br />ultrasound image and being able</p>
<p begin="00:00:12.592" end="00:00:15.369" style="s2">to keep the needle in<br />plane while advancing it</p>
<p begin="00:00:15.369" end="00:00:16.881" style="s2">can be challenging.</p>
<p begin="00:00:16.881" end="00:00:19.445" style="s2">- When you're trying to get<br />a needle down to a nerve,</p>
<p begin="00:00:19.445" end="00:00:22.293" style="s2">let's say three, four centimeters deep,</p>
<p begin="00:00:22.293" end="00:00:24.286" style="s2">and you have a steep needle angle,</p>
<p begin="00:00:24.286" end="00:00:27.097" style="s2">the needle almost becomes invisible.</p>
<p begin="00:00:27.097" end="00:00:28.932" style="s2">So if you don't know where<br />your needle is you have</p>
<p begin="00:00:28.932" end="00:00:31.796" style="s2">a higher chance of hitting<br />things you don't want to</p>
<p begin="00:00:31.796" end="00:00:34.134" style="s2">or placing the needle in<br />places you don't want to.</p>
<p begin="00:00:34.134" end="00:00:35.894" style="s2">- [Voiceover] To help<br />track the advancing needle,</p>
<p begin="00:00:35.894" end="00:00:39.254" style="s2">anesthesiologists often<br />use surrogate markers.</p>
<p begin="00:00:39.254" end="00:00:42.233" style="s2">- We have to move the<br />needle, jiggle the needle,</p>
<p begin="00:00:42.233" end="00:00:44.272" style="s2">see tissue moving but we<br />really don't know where</p>
<p begin="00:00:44.272" end="00:00:45.703" style="s2">the tip of the needle is.</p>
<p begin="00:00:45.703" end="00:00:48.192" style="s2">For the deep block, for<br />something that's difficult</p>
<p begin="00:00:48.192" end="00:00:50.641" style="s2">to see a needle, I would<br />say it doubles the time</p>
<p begin="00:00:50.641" end="00:00:52.190" style="s2">to do a nerve block.</p>
<p begin="00:00:52.190" end="00:00:54.272" style="s2">- [Voiceover] In the past,<br />these challenges have kept</p>
<p begin="00:00:54.272" end="00:00:57.009" style="s2">some anesthesiologists<br />from seeing the advantages</p>
<p begin="00:00:57.009" end="00:01:00.405" style="s2">of ultrasound guided nerve<br />blocks on deep targets.</p>
<p begin="00:01:00.405" end="00:01:02.281" style="s2">- When people start using ultrasound,</p>
<p begin="00:01:02.281" end="00:01:04.119" style="s2">if you can't see the needle,</p>
<p begin="00:01:04.119" end="00:01:06.853" style="s2">it's hard to adopt a new technology.</p>
<p begin="00:01:06.853" end="00:01:09.134" style="s2">- [Voiceover] Sonosite's<br />advanced needle visualization</p>
<p begin="00:01:09.134" end="00:01:13.297" style="s2">has improved the ability to<br />see steep needles dramatically.</p>
<p begin="00:01:13.297" end="00:01:17.460" style="s2">- This new needle visualization<br />technology allows me to see</p>
<p begin="00:01:17.460" end="00:01:21.480" style="s2">the needle probably three<br />to four times brighter</p>
<p begin="00:01:21.480" end="00:01:23.482" style="s2">than if it wasn't there.</p>
<p begin="00:01:23.482" end="00:01:26.255" style="s2">Many times when we turn the algorithm off</p>
<p begin="00:01:26.255" end="00:01:28.418" style="s2">we don't see the needle at all.</p>
<p begin="00:01:28.418" end="00:01:31.656" style="s2">You can see that needle at<br />steep angles, in shallow angles,</p>
<p begin="00:01:31.656" end="00:01:35.777" style="s2">and so you can approach those<br />targets with more confidence.</p>
<p begin="00:01:35.777" end="00:01:37.818" style="s2">- [Voiceover] Sonosite's<br />approach to advanced needle</p>
<p begin="00:01:37.818" end="00:01:41.626" style="s2">visualization maintains the<br />image quality and clarity</p>
<p begin="00:01:41.626" end="00:01:44.739" style="s2">of both the target structure<br />and the surrounding anatomy.</p>
<p begin="00:01:44.739" end="00:01:47.177" style="s2">- When you turn on the needle<br />visualization technology</p>
<p begin="00:01:47.177" end="00:01:50.192" style="s2">it doesn't degrade the rest of<br />the ultrasound image at all.</p>
<p begin="00:01:50.192" end="00:01:53.097" style="s2">- So, if you're trying to<br />see a nerve and you have</p>
<p begin="00:01:53.097" end="00:01:56.605" style="s2">small blood vessels and<br />muscles around that nerve</p>
<p begin="00:01:56.605" end="00:01:58.974" style="s2">we want to see those in a normal picture.</p>
<p begin="00:01:58.974" end="00:02:02.287" style="s2">This new needle visualization<br />technology allows us to see</p>
<p begin="00:02:02.287" end="00:02:06.093" style="s2">that needle and doesn't<br />change our background picture.</p>
<p begin="00:02:06.093" end="00:02:08.428" style="s2">- [Voiceover] Sonosite's<br />advanced visualization</p>
<p begin="00:02:08.428" end="00:02:10.321" style="s2">is also very simple to use.</p>
<p begin="00:02:10.321" end="00:02:13.543" style="s2">Other advanced needle visualization<br />products can be bulky,</p>
<p begin="00:02:13.543" end="00:02:14.732" style="s2">timely to set up,</p>
<p begin="00:02:14.732" end="00:02:18.173" style="s2">and use costly disposable<br />echogenic needles.</p>
<p begin="00:02:18.173" end="00:02:20.598" style="s2">- I want to turn the machine on,</p>
<p begin="00:02:20.598" end="00:02:21.923" style="s2">put the ultrasound probe on,</p>
<p begin="00:02:21.923" end="00:02:23.843" style="s2">put the needle in, and see the needle.</p>
<p begin="00:02:23.843" end="00:02:26.415" style="s2">If I have to spend an extra<br />five, ten minutes setting</p>
<p begin="00:02:26.415" end="00:02:30.050" style="s2">something up or even if I have<br />one of my techs doing that,</p>
<p begin="00:02:30.050" end="00:02:32.012" style="s2">that takes away from their other tasks.</p>
<p begin="00:02:32.012" end="00:02:35.703" style="s2">With this new needle visualization<br />technology we're able</p>
<p begin="00:02:35.703" end="00:02:39.171" style="s2">to not have a disposable,<br />you can use it every time</p>
<p begin="00:02:39.171" end="00:02:42.575" style="s2">for every block and it<br />doesn't add to the cost</p>
<p begin="00:02:42.575" end="00:02:44.169" style="s2">of each nerve block.</p>
<p begin="00:02:44.169" end="00:02:46.615" style="s2">- [Voiceover] Advanced needle<br />visualization is a cost</p>
<p begin="00:02:46.615" end="00:02:50.408" style="s2">effective upgrade requiring no<br />new or additional equipment.</p>
<p begin="00:02:50.408" end="00:02:52.496" style="s2">- Not having to change<br />anything, not having to buy</p>
<p begin="00:02:52.496" end="00:02:56.928" style="s2">a new machine, not having<br />to add parts to the machine,</p>
<p begin="00:02:56.928" end="00:03:01.176" style="s2">is a real benefit to this<br />needle visualization algorithm.</p>
<p begin="00:03:01.176" end="00:03:04.121" style="s2">- This is an excellent<br />teaching tool as it will help</p>
<p begin="00:03:04.121" end="00:03:07.190" style="s2">residents, especially new<br />residents, who are still</p>
<p begin="00:03:07.190" end="00:03:10.205" style="s2">relatively unfamiliar with<br />ultrasound and the skill that</p>
<p begin="00:03:10.205" end="00:03:14.168" style="s2">it requires to be able to<br />easily visualize the needle.</p>
<p begin="00:03:14.168" end="00:03:16.137" style="s2">- Seeing the needle is<br />something that's very important</p>
<p begin="00:03:16.137" end="00:03:19.889" style="s2">anytime you stick a needle<br />in somebody under ultrasound.</p>
<p begin="00:03:19.889" end="00:03:22.829" style="s2">And so, if you're doing any procedure,</p>
<p begin="00:03:22.829" end="00:03:25.641" style="s2">whether it be a nerve<br />block, vascular access,</p>
<p begin="00:03:25.641" end="00:03:28.906" style="s2">seeing that needle is<br />gonna be a game changer,</p>
<p begin="00:03:28.906" end="00:03:31.823" style="s2">especially with those steep angles.</p>