Hybrid guide

A method of inserting a needle into a patient's vein under ultrasound guidance, comprising:

• providing a hybrid guide including:
• a housing having a planar bottom surface and a top surface, each of the planar bottom surface and top surface having two long edges and two short edges, the top surface facing away from the bottom surface;
• first and second echogenic targeting bands provided on the bottom surface of the housing, each of said first and second echogenic targeting bands extending between said two long edges of the base, across a face of the ultrasound transducer such that said first and second echogenic targeting bands form an interference pattern visible under ultrasound visualization, wherein the interference pattern is used to locate the positioning fixture relative to structures visible under ultrasound visualization;
• a pair of long sidewalls provided on and extending orthogonally from the top surface, one said long sidewall of the pair of long sidewalls is attached to each of said two long edges;
• a short axis notch provided on at least one of the pair of long sidewalls, said short axis notch sized and configured to accept a needle;
• a guide release attached to one of said two short edges;
• a long axis needle guide attached to another of said two short edges, said long axis needle guide having a long axis notch;
• and
• a receptacle cooperatively defined by said pair of long sidewalls, said guide release and said long axis needle guide;
• inserting an ultrasound transducer into the receptacle;
• and
• adjusting a position of the housing under ultrasound visualization using the targeting bands such that the short axis notch is centered over the vein;
• inserting the needle into the short axis notch and piercing the subject's skin;
• disengaging the needle from the short axis notch by lifting the hybrid guide off of the needle, rotating the hybrid guide 90 degrees, and placing the needle into engagement with the long axis needle guide;
• and
• advancing the needle into the vein.