okay so now we're taking a look at the left side and interestingly enough we do see the superficial temporal artery where we expect to see it in layer three now keep in mind I said we're going to be filling Layer Two um so this is a great example of being able to monitor your cannula and be sure that you're above that smash layer where the artery is so um now what I'm going to do I'm showing you on this screen we're in Doppler mode and remember when we're using a cannula we like to be on B mode because we don't want to see all that reverberation artifact when we put a cannula in on a Doppler so I'm going to quickly show you now when I have my Probe on we're going to see that this artery is on Doppler and then we're going to go back to our B mode and we can still visualize that layer and we can see that little tiny pulsation in that same layer now I'm going to put it back to Power Doppler just so you can see what I'm talking about here's the artery on Doppler and now back on B mode we still see it so now in your mind's eye you're going to be visualizing the cannula going in the layer Right Above It Layer Two so there's our layer three pulsatile on [ __ ] you can still see it pulsating then we're going to be in Layer Two above it so we've already marked the bottom of our probe we have checked it in the wild we saw what it is like in the wild the bottom of the probe is here um we've made that machete path through our jungle we see what's ahead in the jungle it shouldn't scare us because we're going to be able to stay right above it I've already injected this little spot with lidocaine and so what I'm going to do now is I've got my HIPAA cleanse and I'm just going to re-clean off that spot where I'm gonna go with that entryway to our point A to point B little jungle path so just a tiny little poke hole we don't need to be aggressive with our needle we don't need to shake it all around it's just like a little tiny vocal so now we want to make sure that our device is still on B mode because we're going to be kind of checking our depth we want to make sure we're Layer Two above that artery Layer Two is also a Glide plane so usually when you're in Layer Two it's really easy to move the canyon in and out but I don't use that as a test I have ultrasound to prove I'm in Layer Two and I can see that I'm going to be above the smash and that's what I'm going to check right now is really that superficial layer so I'm gonna just roll my my Pro right over and make sure I'm nice and superficial above the layer of the artery and I'm in that Sub-Q layer just like I want to be right through there you can see that visual of the cannula in that layer two Sub-Q plane like we visualized right before now we can kind of watch the gonna put a little bit of a gel filler and we can watch it go in if we want we are just going to lay that bolus you can see that tissue spreading and now that we kind of know we're in the right plane I'm just going to lay that bolus down here and you don't need to be worried about it turning into like this little mashed potato egg here because you're just going to massage it down a lot of times I'll just have them open their jaw open their jaw and close it a couple times just to help it massage out I usually massage kind of up and back to make sure it spreads nicely and now we have our nice little bolus of an ultrasound guided Temple injection how did that feel okay great so now she has uh a half a syringe on each side and we saw one side where it was a clear machete path the other side we had a clear machete path with a known snake beneath it but that's okay because we were able to visualize but we're right on top so hope you enjoyed thank you
