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We've all been there: a patient with challenging IV access is rushed to the operating room without a secured IV line. Picture this: you're in the OR, surgeons are eagerly waiting, OR techs are bustling with surgical trays, and there, amidst it all, is your patient, looking at you with hopeful eyes after multiple failed IV attempts. The pressure is on. Sure, calling for an ultrasound seems like a viable option, but it comes with its own set of delays – waiting for the equipment, setting up a sterile field, and so on. In such moments, reverting to traditional methods can not only save time but also earn you significant respect for solving a problem that stumped others. So, you apply the tourniquet, meticulously searching for a vein that could accommodate at least a 20G needle – the minimum gauge required for anesthesia in a patient undergoing exploratory laparotomy. Finally, you spot a vein that seems perfect. You cannulate with precision, only to discover that you can't fully insert the catheter. It's hitting a venous valve, hindering both the catheter's insertion and the IV flow. Watch the video to see how we troubleshot this case! Where else to find us: Web- http://www.nysora.com Instagram- / nysora.inc LinkedIN- / nysora-inc Facebook- / nysora Twitter- / nysora TikTok- / nysora_inc --------------------------------------------------------- #nysora #regionalanesthesia #anesthesia Disclaimer: Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publishers have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA's Youtube channel is accurate.