Objective Assessment Metrics for Central Line Simulators: An Exploration of Causal Factors

The Dynamic Haptic Robotic Trainer (DHRT) was developed to minimize the up to 39% of adverse effects experienced by patients during Central Venous Catheterization (CVC) by standardizing CVC training, and provide automated assessments of performance. Specifically, this system was developed to replace manikin trainers that only simulate one patient anatomy and require a trained preceptor to evaluate the trainees’ performance. While the DHRT system provides automated feedback, the utility of this system with real-world scenarios and expertise has yet to be thoroughly investigated. Thus, the current study was developed to determine the validity of the current objective assessment metrics incorporated in the DHRT system through expert interviews. The main findings from this study are that experts do agree on perceptions of patient case difficulty, and that characterizations of patient case difficulty is based on anatomical characteristics, multiple needle insertions, and prior catheterization.

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Right vocal fold paralysis as a result of central venous catheterization

The Journal of Laryngology & Otology ◽

10.1017/s0022215100132153 ◽

1995 ◽

Vol 109 (11) ◽

pp. 1107-1108 ◽

Cited By ~ 21

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.

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Practical procedures

10.1093/med/9780199643219.003.0018 ◽

2012 ◽

Keyword(s):

Central Venous Catheterization ◽

Central Line ◽

Arterial Line ◽

Ultrasound Guided ◽

Central Venous ◽

Central Line Insertion ◽

Vein Cannulation ◽

Arterial Blood ◽

Line Insertion ◽

Venous Catheterization

Arterial blood sampling 784Arterial line insertion: introduction 786Arterial line insertion: over-the-wire technique 786Arterial line insertion: over-the-needle technique 788Central line insertion 790Internal jugular vein cannulation 792Subclavian vein cannulation 794Ultrasound-guided central venous catheterization (1) 796Ultrasound-guided central venous catheterization (2) ...

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Practical procedures

Oxford Handbook of Acute Medicine ◽

10.1093/med/9780199230921.003.15 ◽

2010 ◽

pp. 735-812

Author(s):

Punit S. Ramrakha ◽

Kevin P. Moore ◽

Amir Sam

Keyword(s):

Central Venous Catheterization ◽

Central Line ◽

Arterial Line ◽

Central Venous ◽

Internal Jugular Vein Cannulation ◽

Central Line Insertion ◽

Vein Cannulation ◽

Arterial Blood ◽

Line Insertion ◽

Venous Catheterization

Arterial blood sampling 736 Arterial line insertion 1 738 Arterial line insertion 2 740 Central line insertion 742 Internal jugular vein cannulation 744 Subclavian vein cannulation 746 Ultrasound (US)-guided central venous catheterization 1 748 US-guided central venous catheterization 2 750 Pulmonary artery catheterization 1 752...

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