Ultrasound Guidance Doesn't Ensure Perfect Catheter Placement

When attempting CVC placement on mannequin models, most trainees punctured the posterior wall of the internal jugular vein.

Placing central venous catheters (CVCs) with ultrasound guidance is a widely accepted strategy to lower the number of mechanical complications, such as arterial puncture, hematoma, and pneumothorax. But how good is this technique?

In a prospective single-blind study, researchers asked 25 emergency medicine residents to insert internal jugular (IJ) catheters in a human torso mannequin. All study participants had completed 2-day ultrasound training and had placed at least one ultrasound-guided CVC previously (median number, 8). The residents were given the clinical scenario of a critically ill patient who was receiving anticoagulation (international normalized ratio, 3.5) and who required nonemergent placement of a CVC. Residents were unaware …

Reviewing Author

Neil H. Winawer, MD, FHM

Disclosures

Nothing to disclose

Neil H. Winawer, MD, FHM

Disclosures

Nothing to disclose