Femoral arterial cannulation performed by residents: a comparison between ultrasound‐guided and palpation technique in infants and children undergoing cardiac surgery

Siddik-Sayyid, Sahar M.; Aouad, Marie T.; Ibrahim, Muhammad H.; Taha, Samar K.; Nawfal, Maud; Tfaili, Youssef; Kaddoum, Roland

doi:10.1111/pan.12935

Cited by 23 publications

(31 citation statements)

References 26 publications

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“…Complications related to cannulation (arterial puncture or haematoma) are generally decreased by a factor of 2 to 4 [ 239 , 242 – 244 ], except in one study conducted by Leyvi which did not observe any improvement of the immediate complication rate with ultrasound guidance [ 241 ]. Similar improved results have been reported for arterial cannulation [ 245 – 247 ], with an even greater (four to fivefold) reduction of mechanical complications (haematoma or ischaemia). Several studies have evaluated out-of-plane ultrasound guidance for radial artery cannulation [ 245 , 246 ].…”

Section: Summary Of the Resultssupporting

confidence: 80%

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

Timsit

Baleine

Bernard

et al. 2020

Ann. Intensive Care

125

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The French Society of Intensive Care Medicine (SRLF), jointly with the French-Speaking Group of Paediatric Emergency Rooms and Intensive Care Units (GFRUP) and the French-Speaking Association of Paediatric Surgical Intensivists (ADARPEF), worked out guidelines for the management of central venous catheters (CVC), arterial catheters and dialysis catheters in intensive care unit. For adult patients: Using GRADE methodology, 36 recommendations for an improved catheter management were produced by the 22 experts. Recommendations regarding catheter-related infections’ prevention included the preferential use of subclavian central vein (GRADE 1), a one-step skin disinfection(GRADE 1) using 2% chlorhexidine (CHG)-alcohol (GRADE 1), and the implementation of a quality of care improvement program. Antiseptic- or antibiotic-impregnated CVC should likely not be used (GRADE 2, for children and adults). Catheter dressings should likely not be changed before the 7th day, except when the dressing gets detached, soiled or impregnated with blood (GRADE 2− adults). CHG dressings should likely be used (GRADE 2+). For adults and children, ultrasound guidance should be used to reduce mechanical complications in case of internal jugular access (GRADE 1), subclavian access (Grade 2) and femoral venous, arterial radial and femoral access (Expert opinion). For children, an ultrasound-guided supraclavicular approach of the brachiocephalic vein was recommended to reduce the number of attempts for cannulation and mechanical complications. Based on scarce publications on diagnostic and therapeutic strategies and on their experience (expert opinion), the panel proposed definitions, and therapeutic strategies.

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Section: Summary Of the Resultssupporting

confidence: 80%

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

Timsit

Baleine

Bernard

et al. 2020

Ann. Intensive Care

125

View full text Add to dashboard Cite

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“…catheters placement in children-agreement (quality of evidence B): a few high-quality studies have found that US-guided arterial line placement is faster (shorter time to success and lower number of attempts) and has higher firstattempt cannulation rates regardless of the location [117,118].…”

Section: Pocus-guided Technique Is Helpful For Arterialmentioning

confidence: 99%

International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

et al. 2020

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Background: Point-of-care ultrasound (POCUS) is nowadays an essential tool in critical care. Its role seems more important in neonates and children where other monitoring techniques may be unavailable. POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) aimed to provide evidence-based clinical guidelines for the use of POCUS in critically ill neonates and children. Methods: Creation of an international Euro-American panel of paediatric and neonatal intensivists expert in POCUS and systematic review of relevant literature. A literature search was performed, and the level of evidence was assessed according to a GRADE method. Recommendations were developed through discussions managed following a Quaker-based consensus technique and evaluating appropriateness using a modified blind RAND/UCLA voting method. AGREE statement was followed to prepare this document. Results: Panellists agreed on 39 out of 41 recommendations for the use of cardiac, lung, vascular, cerebral and abdominal POCUS in critically ill neonates and children. Recommendations were mostly (28 out of 39) based on moderate quality of evidence (B and C). Conclusions: Evidence-based guidelines for the use of POCUS in critically ill neonates and children are now available. They will be useful to optimise the use of POCUS, training programs and further research, which are urgently needed given the weak quality of evidence available.

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“…Fifteen studies (4%) measured the success rates of various ultrasoundguided procedures (Kirkpatrick IV) completed by residents after undergoing POCUS education. 16,62,81,181,[195][196][197][198][199][200][201][202][203][204][205] Procedures included ultrasound guided regional anesthesia, 81,181,195,196,[198][199][200]202,204 paracentesis, 16 vascular access, 62,201,203,205 and renal biopsy. 197 Eleven studies found improvements in procedural success after an ultrasound curriculum compared to controls, 16,62,81,[195][196][197][198][199][200][201]205 two found no difference in outcomes compared to controls, 202,203 and two found positive outcomes, but did not use controls.…”

Section: Procedural Success Ratesmentioning

confidence: 99%

Teaching Point-of-Care Ultrasound in Medicine

Moses

Weng

Orchanian‐Cheff

et al. 2020

Can Journ Gen Int Med

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Point-of-care ultrasound (POCUS) is an important tool for diagnosis and management across medical specialties. This scoping review consolidates POCUS education literature, examining how curricula are developed, implemented, and assessed. We identify literature gaps, explore directions for further research, and provide recommendations for curriculum development, implementation, and improvement. MethodsWe conducted a scoping review per the framework outlined by Arksey & O’Malley. A systematic search of the MEDLINE, EMBASE, Cochrane, ERIC, Web of Science, and Scopus databases was conducted to identify published, English language literature, on POCUS education in undergraduate or graduate medical training.ResultsOf 6,164 articles identified, 421 were analyzed in depth. Curricular content included diverse diagnostic and therapeutic applications, varying significantly by specialty. Teaching modalities included in-person didactics (74%), human models (58%), simulation (33%), and web-based didactics (18%). Several studies showed better outcomes for structured vs. apprenticeship curricula, hands-on teaching vs. didactic lectures, and human models vs. simulators. Web-based didactics were as effective as in-person didactics and conveyed benefits in reusability, cost, and instructor time. Dedicated electives and boot-camps were identified as effective. Few curricula assessed knowledge retention (5%), clinical decision making (3%), learner behavior (12%), or patient outcomes (6%). ConclusionScholarly POCUS education literature is expanding. Curricular content varies and should be tailored to specialty needs. Structured curricula utilizing hands-on learning, electives, and boot-camps can enhance educational outcomes. Higher-level outcomes such as knowledge retention, clinical decision making, learner behavior, and patient outcomes, are lacking and should be a focus of further researchResumeL’échographie au point de service (POCUS) est un outil important pour le diagnostic et la gestion dans toutes les spécialités médicales. Cette étude de portée consolide la littérature éducative POCUS, en examinant comment les programmes d’enseignement sont élaborés, mis en œuvre et évalués. Nous identifions les lacunes de la littérature, explorons les directions à prendre pour des recherches plus approfondies et fournissons des recommandations pour le développement, la mise en œuvre et l’amélioration des programmes d’enseignement. MéthodesNous avons procédé à un examen de portée conformément au cadre défini par Arksey & O’Malley. Une recherche systématique dans les bases de données MEDLINE, EMBASE, Cochrane, ERIC, Web of Science et Scopus a été effectuée afin d’identifier les publications en langue anglaise sur l’enseignement POCUS dans le cadre de la formation médicale de premier ou de deuxième cycle. RésultatsSur les 6 164 articles identifiés, 421 ont fait l’objet d’une analyse approfondie. Le contenu des programmes d’études comprenait diverses applications diagnostiques et thérapeutiques, variant considérablement selon les spécialités. Les modalités d’enseignement comprenaient la didactique en personne (74 %), les modèles humains (58 %), la simulation (33 %) et la didactique basée sur le web (18 %). Plusieurs études ont montré de meilleurs résultats pour les programmes structurés par rapport aux programmes d’apprentissage, l’enseignement pratique par rapport aux cours magistraux didactiques, et les modèles humains par rapport aux simulateurs. La didactique basée sur le web était aussi efficace que la didactique en personne et présentait des avantages en termes de réutilisation, de coût et de temps de l’instructeur. Les cours optionnels et les camps d’entraînement ont été jugés efficaces. Peu de programmes ont évalué la rétention des connaissances (5 %), la prise de décision clinique (3 %), le comportement des apprenants (12 %) ou les résultats pour les patients (6 %). ConclusionLa littérature éducative POCUS est en pleine expansion. Le contenu des programmes d’études varie et doit être adapté aux besoins spécifiques. Des programmes structurés utilisant un apprentissage pratique, des cours optionnels et des camps d’entraînement peuvent améliorer les résultats scolaires. Des résultats de plus haut niveau, tels que la rétention des connaissances, la prise de décision clinique, le comportement de l’apprenant et les résultats pour le patient, font défaut et devraient faire l’objet de recherches plus approfondies.

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Femoral arterial cannulation performed by residents: a comparison between ultrasound‐guided and palpation technique in infants and children undergoing cardiac surgery

Abstract: Ultrasound-guided femoral arterial cannulation in children when performed by anesthesia residents is superior to the palpation technique based on the reduction of the time taken for attempted cannulation and the number of attempts, and improvement in first attempt success.

Cited by 23 publications

References 26 publications

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

Teaching Point-of-Care Ultrasound in Medicine

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