Decrease in central venous catheter placement due to use of ultrasound guidance for peripheral intravenous catheters

Au, Alexander; Rotte, Masashi; Grzybowski, Robert J.; Ku, Bon; Fields, J. Matthew

doi:10.1016/j.ajem.2012.04.016

Cited by 128 publications

(96 citation statements)

References 14 publications

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“…IV catheter placement was named along with venipuncture, arterial puncture, thoracentesis, lumbar puncture, nasogastric tube placement, Foley catheter insertion and suturing of lacerations [8]. However, even 10 years after that report was published it was found that students are not becoming proficient in these basic procedural skills and are either simply not performing them or do not feel confident in their skills [1-3].…”

Section: Introductionmentioning

confidence: 99%

“…This lack of experience becomes even more critical as physicians, more likely to be interns, are often the final stop in gaining IV placement in difficult patients, such as those with a history of fragile veins or IV drug use [4]. If the physician fails to place a peripheral IV during life saving measures, a central venous catheter is often placed instead, which is associated with a 5-10% complication rate [6-8]. …”

Section: Introductionmentioning

confidence: 99%

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Successful intravenous catheterization by medical students

Woelfel

Takabe

2016

Journal of Surgical Research

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Background Intravenous (IV) catheter placement is one of the most basic and essential medical procedures. However, IV placement can be a source of anxiety for medical students as it is often their first procedural patient care. We sought to investigate the factors that impact the success rate of this skill and to determine at what rate students improve. Materials and methods A confidential web-based survey was distributed to a total of 367 third and fourth year students at Virginia Commonwealth University School of Medicine. The responses were collected over a 2-week period in July 2015. Results The response rate was 49.0% (180/367). 65.5% of the M3s and 21.8% of the M4s have never had an opportunity to place an IV. The success rate was higher in students with prior experience as laboratory researchers (86.6%, p=0.014) as well as Emergency Medical Technicians (81.4%, p=0.038) when compared to students with no experience. Prior preparation such as reading, watching videos or even lectures did not increase the success rate. Success rates rapidly improved from 47% for the first attempt to 86% for the fifth attempts. Conclusion A significant percentage of students did not have opportunities to attempt IV catheter placement. We found prior experience, not only as an EMT but also as a lab researcher, significantly increased the success rate. Prior preparations did not improve success rate and most of the students were successful after only 5 attempts.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Successful intravenous catheterization by medical students

Woelfel

Takabe

2016

Journal of Surgical Research

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“…Ultrasound prevented the need for central venous cannula placement in 85% of these patients with difficult IV access. [21] We found that central line 'rescue' was required only in one patient (6.2%) belonging to the US group, while 2 cases (12.4%) needed it in the BP group. The use of ultrasonography will minimize, if not obviate the need for central line placements when initial blind attempts fail to cannulate difficult IV access patients.…”

Section: Discussionmentioning

confidence: 70%

A Comparative Study on Ultrasound–guided Peripheral Intravenous Access Versus Traditional Blind Percutaneous Approach in Patients With Difficult Intravenous Access

Maryam¹,

Akkarapampil²,

Bhat³

2016

jemds

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“…Use of ultrasound provides a very real alternative to more invasive approaches such as central venous access, [6, 13] external jugular vein, [14] venous cutdown or intraosseous access. In addition, ultrasound-guided PIV cannulation has been shown not to pose a significant infection risk [15].…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound-guided peripheral vascular access is a safe alternative to central line placement and could be used instead in up to 85% of patients classified as having difficult IV access [6]. Training students and staff to locate and access deep peripheral veins under ultrasound guidance may therefore lead to fewer central line placements and, consequently, a reduced incidence of central line-related complications.…”

Section: Introductionmentioning

confidence: 99%

A randomised crossover study to compare the cross-sectional and longitudinal approaches to ultrasound-guided peripheral venepuncture in a model

Griffiths¹,

Carnegie²,

Kendall³

et al. 2017

Crit Ultrasound J

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BackgroundUltrasound-guided peripheral intravenous access may present an alternative to central or intraosseous access in patients with difficult peripheral veins. Using venepuncture of a phantom model as a proxy, we investigated whether novice ultrasound users should adopt a cross-sectional or longitudinal approach when learning to access peripheral veins under ultrasound guidance. This result would inform the development of a structured training method for this procedure.MethodsWe conducted a randomised controlled trial of 30 medical students. Subjects received 35 min of training, then attempted to aspirate 1 ml of synthetic blood from a deep vein in a training model under ultrasound guidance. Subjects attempted both the cross-sectional and longitudinal approaches. Group 1 used cross-sectional first, followed by longitudinal. Group 2 used longitudinal first, then cross-sectional. We measured the time from first puncture of the model’s skin to aspiration of fluid, and the number of attempts required. Subjects also reported difficulty ratings for each approach. Paired sample t-tests were used for statistical analysis.ResultsThe mean number of attempts was 1.13 using the cross-sectional approach, compared with 1.30 using the longitudinal approach (p = 0.17). Mean time to aspiration of fluid was 45.1 s using the cross-sectional approach and 52.8 s using the longitudinal approach (p = 0.43). The mean difficulty score out of 10 was 3.97 for the cross-sectional approach and 3.93 for the longitudinal approach (p = 0.95).ConclusionsWe found no significant difference in effectiveness between the cross-sectional and longitudinal approaches to ultrasound-guided venepuncture when performed on a model. We believe that both approaches should be included when teaching ultrasound-guided peripheral vascular access. To confirm which approach would be best in clinical practice, we advocate future testing of both approaches on patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s13089-017-0064-1) contains supplementary material, which is available to authorized users.

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Decrease in central venous catheter placement due to use of ultrasound guidance for peripheral intravenous catheters

Cited by 128 publications

References 14 publications

Successful intravenous catheterization by medical students

Successful intravenous catheterization by medical students

A Comparative Study on Ultrasound–guided Peripheral Intravenous Access Versus Traditional Blind Percutaneous Approach in Patients With Difficult Intravenous Access

A randomised crossover study to compare the cross-sectional and longitudinal approaches to ultrasound-guided peripheral venepuncture in a model

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