Randomized, prospective, observational simulation study comparing residents’ needle- guided vs free-hand ultrasound techniques for central venous catheter.

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Presentation transcript:

Randomized, prospective, observational simulation study comparing residents’ needle- guided vs free-hand ultrasound techniques for central venous catheter access† R.D. Ball, N.E. Scouras, S. Orebaugh, J. Wilde, T. Sakai British Journal of Anaesthesia Volume 108, Issue 1, Pages 72-79 (January 2012) DOI: 10.1093/bja/aer329 Copyright © 2012 The Author(s) Terms and Conditions

Fig 1 InfinitiTM CIVCO Medical Solutions device attached to the iLook® 25 bedside ultrasound unit transducer. British Journal of Anaesthesia 2012 108, 72-79DOI: (10.1093/bja/aer329) Copyright © 2012 The Author(s) Terms and Conditions

Fig 2 Short-axis ultrasound view of the Blue PhantomTM training model. The superficial tubing is venous tubing (V), which simulates the internal jugular vein. The other tubing is arterial tubing (A), which simulates the carotid artery. British Journal of Anaesthesia 2012 108, 72-79DOI: (10.1093/bja/aer329) Copyright © 2012 The Author(s) Terms and Conditions

Fig 3 The fraction of time the needle tip was visualized during each task. NG had significantly higher fraction (P<0.001) compared with the other two techniques. The box plot shows the median, lower and upper quartiles (25–75%), and the minimum and the maximum. NG, long axis with needle guide; L-FH, long-axis free hand; S-FH, short-axis free hand. British Journal of Anaesthesia 2012 108, 72-79DOI: (10.1093/bja/aer329) Copyright © 2012 The Author(s) Terms and Conditions

Fig 4 The fraction of time the needle tip was visualized during the task per class. The column graphs show the mean and standard deviation (sd). There was no statistical difference among the classes per technique. NG, long axis with needle guide; L-FH, long-axis free hand; S-FH, short-axis free hand. British Journal of Anaesthesia 2012 108, 72-79DOI: (10.1093/bja/aer329) Copyright © 2012 The Author(s) Terms and Conditions

Fig 5 The procedural time required for each task. S-FH had significantly shorter time (P=0.012) compared with the other two techniques. The box plot shows the median, lower and upper quartiles (25–75%), and the minimum and the maximum. NG, long-axis with needle guide; L-FH, long-axis free hand; S-FH, short-axis free hand. British Journal of Anaesthesia 2012 108, 72-79DOI: (10.1093/bja/aer329) Copyright © 2012 The Author(s) Terms and Conditions

Fig 6 The procedural time required for each task per class. The column graphs show the mean and sd. CA1 required a significantly longer time to complete L-FH among the three classes of training (P=0.031: P<0.05 vs CA3) and among the three techniques (P=0.049: P<0.05 vs S-FH). NG, long-axis with needle guide; L-FH, long-axis free hand; S-FH, short-axis free hand. British Journal of Anaesthesia 2012 108, 72-79DOI: (10.1093/bja/aer329) Copyright © 2012 The Author(s) Terms and Conditions

Fig 7 The results of the post-study resident survey (Appendix). The column graphs show the mean and sd. British Journal of Anaesthesia 2012 108, 72-79DOI: (10.1093/bja/aer329) Copyright © 2012 The Author(s) Terms and Conditions