Advanced Surface System for Central Venous Catheter Insertion Training

2020 ◽  
Author(s):  
Dailen Brown ◽  
Haroula Tzamaras ◽  
Jessica M. Gonzalez-Vargas ◽  
Scarlett Miller ◽  
Jason Moore
Keyword(s):  
Sensor Array ◽  
Low Cost ◽  
Venous Catheter ◽  
Maximum Deviation ◽  
Central Venous ◽  
Insertion Depth ◽  
Hall Effect Sensor ◽  
Cost System ◽  
Venous Catheterization ◽  
Measured Position

Abstract An advanced surface for Central Venous Catheterization (CVC) training and evaluation was designed using sensorization techniques, including the use of a hall effect sensor array to measure the insertion depth of a catheter. The sensor array was tested for accuracy in both static and dynamic scenarios, and was found to be sufficiently accurate; measuring position with an accuracy of ±1.1 mm on average. The highest deviations in measured positions were located at the extreme ends of the array where calculations rely on only a single sensor. The maximum deviation in measured position was found to be 3.5 mm. This low-cost system of catheter measurement has the potential to improve feedback and assessment of CVC training.

Nosocomial Infection and Multidrug-Resistant Bacteria Surveillance in Intensive Care Units: A Survey in France

2005 ◽  
Vol 26 (1) ◽  
pp. 13-20 ◽  
Author(s):  
François L'Hériteau ◽  
Corinne Alberti ◽  
Yves Cohen ◽  
Gilles Troché ◽  
Pierre Moine ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Multiple Correspondence Analysis ◽  
Venous Catheter ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Central Venous ◽  
Venous Catheterization ◽  
Structural Variables ◽  
Tract Infections

AbstractObjectives:To evaluate nosocomial infection (NI) surveillance strategies in French ICUs and to identify similar patterns defining subsets within which comparisons can be made.Design:A questionnaire was sent to all French ICUs, and a random sample of nonresponders was interviewed.Participants:Three hundred ninety-five responder ICUs (69%) in France.Results:In 282 ICUs (71%), a dedicated ICU staff member was responsible for infection control activities. The microbiology laboratory was usually in the hospital (90%) and computerized (94%) but issued regular hospital microbiology records in only 48% of cases. Patients receiving mechanical ventilation, central venous catheterization, and urinary catheterization were 90%, 79%, and 60%, respectively. Patients were screened for carriage of mul-tidrug-resistant bacteria on admission and during the stay in 70% and 60% of ICUs, respectively, most often targeting MRSA. Quantitative cultures were used to diagnose ventilator-associated pneumonia (VAP) in 90% of ICUs, including distal specimens in 80% and bronchoscopy specimens in 60%. Quantitative central venous catheter (CVC)-segment cultures were used in 70% of ICUs. All CVCs were cultured routinely in 53% of the ICUs. Despite wide variations in infection control and surveillance strategies, multiple correspondence analysis identified 13 key points (4 structural variables and 9 variables concerning the diagnosis of VAP, the surveillance and diagnosis of catheter-related and urinary tract infections, and the mode of screening of MRSA carriers) that categorize the variability of French ICUs' approaches to NIs.Conclusion:This study revealed profound differences in N1 surveillance strategies across ICUs, indicating a need for caution when using N1 surveillance data for comparisons and benchmarking.

Pre- and post-review of a standardized ultrasound-guided central venous catheterization curriculum evaluating procedural skills acquisition and clinician confidence

2019 ◽  
Vol 21 (4) ◽  
pp. 440-448 ◽  
Author(s):  
Timothy R Spencer ◽  
Amy J Bardin-Spencer
Keyword(s):  
Central Venous Catheter ◽  
Central Venous Catheterization ◽  
Venous Catheter ◽  
Catheter Insertion ◽  
Central Venous Catheter Insertion ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Clinical Simulation ◽  
Venous Catheterization ◽  
Simulation Based

Background: To evaluate novice and expert clinicians’ procedural confidence utilizing a blended learning mixed fidelity simulation model when applying a standardized ultrasound-guided central venous catheterization curriculum. Methods: Simulation-based education and ultrasound-guided central venous catheter insertion aims to provide facility-wide efficiencies and improves patient safety through interdisciplinary collaboration. The objective of this quality improvement research was to evaluate both novice (<50) and expert (>50) clinicians’ confidence across 100 ultrasound-guided central venous catheter insertion courses were performed at a mixture of teaching and non-teaching hospitals across 26 states within the United States between April 2015 and April 2016. A total of 1238 attendees completed a pre- and post-survey after attending a mixed method clinical simulation course. Attendees completed a 4-h online didactic education module followed by 4 h of hands-on clinical simulation stations (compliance/sterile technique, needling techniques, vascular ultrasound assessment, and experiential complication management). Results: The use of a standardized evidence-based ultrasound-guided central venous catheter curriculum improved confidence and application to required clinical tasks and knowledge across all interdisciplinary specialties, regardless of level of experience. Both physician and non-physician groups resulted in statistically significant results in both procedural compliance ( p < 0.001) and ultrasound skills ( p < 0.001). Conclusion: The use of a standardized clinical simulation curriculum enhanced all aspects of ultrasound-guided central venous catheter insertion skills, knowledge, and improved confidence for all clinician types. Self-reported complications were reported at significantly higher rates than previously published evidence, demonstrating the need for ongoing procedural competencies. While there are growing benefits for the role of simulation-based programs, further evaluation is needed to explore its effectiveness in changing the quality of clinical outcomes within the healthcare setting.

scholarly journals Ultrasound to Detect Central Venous Catheter Placement Associated Complications

2020 ◽  
Vol 132 (4) ◽  
pp. 781-794 ◽  
Author(s):  
Jasper M. Smit ◽  
Mark E. Haaksma ◽  
Endry H. T. Lim ◽  
Thei S. Steenvoorden ◽  
Michiel J. Blans ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Diagnostic Accuracy ◽  
Central Venous Catheterization ◽  
Venous Catheter ◽  
Reference Standard ◽  
Central Venous ◽  
Central Venous Catheter Placement ◽  
X Ray ◽  
Venous Catheterization ◽  
Chest X Ray

Abstract Background Mechanical complications arising after central venous catheter placement are mostly malposition or pneumothorax. To date, to confirm correct position and detect pneumothorax, chest x-ray film has been the reference standard, while ultrasound might be an accurate alternative. The aim of this study was to evaluate diagnostic accuracy of ultrasound to detect central venous catheter malposition and pneumothorax. Methods This was a prospective, multicenter, diagnostic accuracy study conducted at the intensive care unit and postanesthesia care unit. Adult patients who underwent central venous catheterization of the internal jugular vein or subclavian vein were included. Index test consisted of venous, cardiac, and lung ultrasound. Standard reference test was chest x-ray film. Primary outcome was diagnostic accuracy of ultrasound to detect malposition and pneumothorax; for malposition, sensitivity, specificity, and other accuracy parameters were estimated. For pneumothorax, because chest x-ray film is an inaccurate reference standard to diagnose it, agreement and Cohen’s κ-coefficient were determined. Secondary outcomes were accuracy of ultrasound to detect clinically relevant complications and feasibility of ultrasound. Results In total, 758 central venous catheterizations were included. Malposition occurred in 23 (3.3%) out of 688 cases included in the analysis. Ultrasound sensitivity was 0.70 (95% CI, 0.49 to 0.86) and specificity 0.99 (95% CI, 0.98 to 1.00). Pneumothorax occurred in 5 (0.7%) to 11 (1.5%) out of 756 cases according to chest x-ray film and ultrasound, respectively. In 748 out of 756 cases (98.9%), there was agreement between ultrasound and chest x-ray film with a Cohen’s κ-coefficient of 0.50 (95% CI, 0.19 to 0.80). Conclusions This multicenter study shows that the complication rate of central venous catheterization is low and that ultrasound produces a moderate sensitivity and high specificity to detect malposition. There is moderate agreement with chest x-ray film for pneumothorax. In conclusion, ultrasound is an accurate diagnostic modality to detect malposition and pneumothorax. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Vias para Nutrição Artificial na Criança (II): Acessos Parentéricos

2014 ◽  
Vol 27 (6) ◽  
pp. 767
Author(s):  
José Estevão-Costa
Keyword(s):  
Parenteral Nutrition ◽  
Central Venous Catheterization ◽  
Venous Catheter ◽  
Venous Access ◽  
The Body ◽  
Central Catheter ◽  
Maintenance Care ◽  
Central Venous ◽  
Venous Catheterization

Parenteral nutrition is crucial when the use of the gastrointestinal tract is not feasible. This article addresses the main techniques for parenteral access in children, its indications, insertion details and maintenance, and complications. The type of venous access is mainly dictated by the expected duration of parenteral nutrition and by the body weight/stature. The peripheral access is viable and advantageous for parenteral nutrition of short duration (&lt; 2 weeks); a tunneled central venous catheter (Broviac) is usually necessary in long-term parenteral nutrition (&gt; 3 weeks); a peripherally introduced central catheter is an increasingly used alternative. Parenteral<br />accesses are effective and safe, but the morbidity and mortality is not negligible particularly in cases of short bowel syndrome. Most complications are related to the catheter placement and maintenance care, and can be largely avoided when the procedures are carried out by experienced staff under strict protocols.<br /><strong>Keywords:</strong> Child; Parenteral Nutrition; Catheterization, Central Venous; Catheterization, Peripheral.

Right vocal fold paralysis as a result of central venous catheterization

1995 ◽  
Vol 109 (11) ◽  
pp. 1107-1108 ◽  
Author(s):  
D. P. Martin-Hirsch ◽  
C. J. R. Newbegin
Keyword(s):  
Vocal Fold ◽  
Central Venous Catheterization ◽  
Venous Catheter ◽  
Central Line ◽  
Vocal Fold Paralysis ◽  
Central Venous ◽  
Central Lines ◽  
Central Line Insertion ◽  
Venous Catheterization ◽  
Bilateral Vocal Fold Paralysis

AbstractInvasive peri- and post-operative monitoring is being increasingly utilized, and a corresponding increase of concomitant complications are becoming apparent.Two cases of complete right vocal fold paralysis are reported as a possible complication of right central venous catheterization. The underlying aetiology of this complication is presumed to be either direct trauma at the time of introduction of the central venous catheter, or by thrombosis and fibrosis around the recurrent laryngeal or vagus nerve. It is suggested that multiple attempts at cannulation and leaving the central line in situ for long periods increases the risk of this complication.When the integrity of the left recurrent laryngeal nerve or vagus is jeopardized or must be sacrificed during surgery, it is suggested that ipsilateral central lines are inserted to minimize the risk of bilateral vocal fold paralysis.Cases of vocal fold paralysis secondary to central line insertion should be followed expectantly and surgical intervention only be considered after 12 months review.

scholarly journals Jugular Venous Catheterization: A Case of Knotting

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
E. Erkılıç ◽  
M. Aksoy ◽  
T. Gümüş ◽  
S. Sarı ◽  
E. Kesimci
Keyword(s):  
Central Venous Catheter ◽  
Literature Review ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Central Catheter ◽  
Drug Infusion ◽  
Central Venous ◽  
Venous Catheterization ◽  
Invasive Method ◽  
The Right

A 79-year-old woman, diagnosed for cancer of the ovary, had a central catheter that was placed with difficulty through the right internal jugular vein intraoperatively. After oophorectomy, it was realized that the catheter was knotted. Thus, the central venous catheter was removed successfully using a traction technique in the operating room. Central venous catheter use may result in various complications, although it has been used as an invasive method for hemodynamic monitoring and fluid and drug infusion. Here, we present catheter knotting in a case with solutions for this complication, under literature review.

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