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Comparison of Ultrasound-Guided Central Venous Catheter Placement Techniques Using an Easily Made Simulator Model

Published online by Cambridge University Press:  05 April 2021

Hasan Idil Open the ORCID record for Hasan Idil [Opens in a new window]  and
Turgay Yilmaz Kilic
Hasan Idil*
Affiliation:
Department of Emergency Medicine, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
Turgay Yilmaz Kilic
Affiliation:
Department of Emergency Medicine, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
*
Correspondence: Hasan Idil, MD University of Health Sciences Tepecik Training and Research Hospital Department of Emergency Medicine Yenisehir, 35120 Izmir, Turkey E-mail: [email protected]
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Abstract

Objectives:

Central venous catheter (CVC) placement is an important procedure which is frequently performed in the emergency department (ED) and can cause serious complications. The aim of this study is to introduce a simulation-based tissue model for ultrasound (US)-guided central venous access practices and to compare the effectiveness of static and dynamic US techniques through this model.

Methods:

This was a prospective study on US-guided CVC placement techniques simulated with a chicken tissue model. This model is based on the principle of placing two cylindrical balloons filled with colored water (red for arterial and blue for venous) between a raw chicken breast and wrapping the formed structure with plastic wrap. The study was conducted in an academic tertiary care hospital with Emergency Medicine (EM) residents who have received basic US training, including vascular access procedures. All participants performed simulated CVC placement procedures with both static and dynamic US techniques. At the end of the study, the practitioners were asked to rate usefulness of these techniques between one and ten (one was the lowest and ten was the highest score).

Results:

A total of 32 EM residents were included in the study. Their median age was 29 (IQR = 27 - 31) years and 72% of them were male. Their median duration in ED was 19 (IQR = 12 - 34) months. According to the results of simulated CVC placement procedures, there was no significant difference between the static and dynamic US techniques in terms of puncture numbers, procedure durations, and success rates. However, according to the usefulness scores given by the practitioners, the dynamic US technique was found to be more useful (P < .001).

Conclusions:

The chicken tissue model is a convenient tool for simulating US-guided CVC placement procedures. The dynamic US technique is considered to be more useful in this field than the static technique, but the results of practitioner-dependent practices may not always support this generalization.

Keywords

central venous cathetersimulationtechniqueultrasoundvascular access
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 3 , June 2021 , pp. 301 - 305
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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References

Lamperti, M, Bodenham, AR, Pittiruti, M, et al. International evidence-based recommendations on ultrasound-guided vascular access. Intensive Care Med. 2012;38(7):1105–1117.CrossRefGoogle ScholarPubMed
Troianos, CA, Hartman, GS, Glas, KE, et al. Special articles: guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. Anesth Analg. 2012;114(1):46–72.CrossRefGoogle ScholarPubMed
Franco-Sadud, R, Schnobrich, D, Mathews, BK, et al. Recommendations on the use of ultrasound guidance for central and peripheral vascular access in adults: a position statement of the Society of Hospital Medicine. J Hosp Med. 2019(6);14:E1–E22.CrossRefGoogle Scholar
Farjad Sultan, S, Shorten, G, Iohom, G. Simulators for training in ultrasound guided procedures. Med Ultrason. 2013;15(2):125–131.CrossRefGoogle ScholarPubMed
Davidson, IJA, Yoo, MC, Biasucci, DG, et al. Simulation training for vascular access interventions. J Vasc Access. 2010;11(3):181–190.CrossRefGoogle ScholarPubMed
Rippey, JC, Blanco, P, Carr, PJ. An affordable and easily constructed model for training in ultrasound-guided vascular access. J Vasc Access. 2015;16(5):422–427.CrossRefGoogle ScholarPubMed
Airapetian, N, Maizel, J, Langelle, F, et al. Ultrasound-guided central venous cannulation is superior to quick-look ultrasound and landmark methods among inexperienced operators: a prospective randomized study. Intensive Care Med. 2013;39(11):1938–1944.CrossRefGoogle ScholarPubMed
Wu, SY, Ling, Q, Cao, LH, et al. Real-time two-dimensional ultrasound guidance for central venous cannulation: a meta-analysis. Anesthesiology. 2013;118(2):361–375.CrossRefGoogle ScholarPubMed
Nachshon, A, Mitchell, JD, Mueller, A, et al. Expert evaluation of a chicken tissue-based model for teaching ultrasound-guided central venous catheter insertion. J Educ Perioper Med. 2017;19(1):E503.Google ScholarPubMed
Sanchez-de-Toledo, J, Villaverde, I. Advanced low-cost ultrasound-guided vascular access simulation: the chicken breast model. Pediatr Emerg Care. 2017;33(9):e43–e45.CrossRefGoogle ScholarPubMed