Answer by Gavin Harrington. Confidence votes 4.0K. A bitch is a female canine. The same word is often used in reference to something unpleasant or difficult to do. E.g- We had to deliver twenty large crates to the top floor, and the lift was out-that job was a bitch.
After reading this article, the physician should be able to: 1  Proper equipment setup and positioning for UGCVC. 2  Ultrasound criteria for possible difficult UGCVC. 3  Procedural steps involved in locating, accessing and cannulating the internal jugular vein with ultrasound guidance.
Also, the most economical (fuel efficient) position for the IMRC is in the CLOSED position.....which requires the actuators to function. One could fasten the IMRC closed....but you would still get a CEL for this as the PCM would not get a open reading when it was expecting it.