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When using the transverse orientation during needle insertion, extra care must be taken to ensure proper localization of the needle tip. The exact needle entry site can be obtained by placing the needle flat on the skin under the ultrasound probe with a layer of gel in between. This will result in seeing the needle at the top of the screen on ultrasound with a shadow directly below. If the shadow is lined up with the target the needle is in the correct position. That position can then be marked.
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