For every field including medicine and specifically Interventional radiology, their are rules that must be followed. The following rules are non-negotiable.
- The natural resting place of a hydrophilic guidewire is on the floor.
- If you feel resistance, stop pushing.
- Always ensure the bag is closed before you attach.
- If the histology report reads ‘foam’ you’ve gone too far.
- Every puncture is optional. Every haemostasis is mandatory.
- When in doubt, keep the guidewire in. No one has ever complained about the access being too good.
- Never let a procedure take you somewhere your brain didn’t get to five minutes earlier.
- Always try to keep the number of wires you put in equal to the number of wires you take out.
- Puncturing isn’t dangerous. Bleeding is what’s dangerous.
- It’s always better to be watching and wishing you were poking wires about than poking wires about and wishing you were watching.
- If you haven’t encountered complications during a procedure, you haven’t done enough of them.
- There are three simple rules for a smooth procedure. Unfortunately no one knows what they are.
- You start with a bag full of luck and an empty bag of experience. The trick is to fill the bag of experience before you empty the bag of luck.
- With enough time and radiation a wire can go anywhere.
- If your sample contains bowel, renal tissue and muscle, you probably missed the liver.
- Good judgment comes from experience. Unfortunately, the experience usually comes from bad judgment.
- It’s always a good idea to keep anything with a pointy end facing away from you.
- Keep looking around. There is always something you have missed. Isn’t that why they created checklists!
- Remember, blood pressure is not just a good idea. It is essential.
- There are old interventional radiologists and there are bold interventional radiologists. However, there are no old, bold interventional radiologists.
- All bleeding stops eventually.
