BackgroundWhile insertion of CVC (central venous catheter) is common, it is an intricate procedure and not risk-free. Traditionally, inexperienced residents learn to insert CVC on real patients and thus can put patients' life at risk. One way to reduce medical errors is to use high-fidelity simulation for training tomorrow's practitioners on ultrasound-guided CVC insertion.ObjectiveTo evaluate the efficacy of medical simulation based learning course on knowledge and skills improvement on ultrasound-guided CVC insertion.MethodsA pre-assessment was performed through a pre-test and hands-on skill assessment for central line insertion under U/S guidance (Internal Jugular, Subclavian or Femoral lines) utilizing a standardized checklist. All candidates then attended one day course that included theoretical and hands-on simulation training using phantoms. A post-test and hands-on assessment was performed at the end of the day.ResultsTwenty residents from Internal Medicine and Paediatrics were enrolled in the study at King Fahad Medical City Simulation Center. There was significant improvement in the knowledge based training: 90% showed significant increase in their MCQ scores (p<0.001), 10% had equal scores and none showed decline in their scores. For the hands-on skills: All 20 candidates showed significant improvement in their skills (p<0.001).ConclusionA one day simulation course on CVC insertion under ultrasound guidance significantly improves the knowledge and skills for residents in training programs.RecommendationsSuch courses and other similar should be compulsory for all Residents training programs as it is called safe training.
Rare central venous catheter malposition – an ultrasound-guided approach would be helpful: a case report