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The Rules of Interventional Radiology

Everyone should know the rules of interventional radiology.  They are non-negotiable.

  1. The natural resting place of a hydrophilic guidewire is on the floor.
  2. If you feel resistance, stop pushing.
  3. Always ensure the bag is closed before you attach.
  4. If the histology report reads ‘foam’ you’ve gone too far.
  5. Every puncture is optional. Every haemostasis is mandatory.
  6. When in doubt, keep the guidewire in. No one has ever complained about the access being too good.
  7. Never let a procedure take you somewhere your brain didn’t get to five minutes earlier.
  8. Always try to keep the number of wires you put in equal to the number of wires you take out.
  9. Puncturing isn’t dangerous. Bleeding is what’s dangerous.
  10. It’s always better to be watching and wishing you were poking wires about than poking wires about and wishing you were watching.
  11. If you haven’t encountered complications during a procedure, you haven’t done enough of them.
  12. There are three simple rules for a smooth procedure. Unfortunately no one knows what they are.
  13. 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.
  14. With enough time and radiation a wire can go anywhere.
  15. If your sample contains bowel, renal tissue and muscle, you probably missed the liver.
  16. Good judgment comes from experience. Unfortunately, the experience usually comes from bad judgment.
  17. It’s always a good idea to keep anything with a pointy end facing away from you.
  18. Keep looking around. There is always something you have missed. Isn’t that why they created checklists!
  19. Remember, blood pressure is not just a good idea. It is essential.
  20. There are old interventional radiologists and there are bold interventional radiologists. However, there are no old, bold interventional radiologists.
  21. All bleeding stops eventually.

Got any others?  Let us know via the contact us page!


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