Comparison of Ultrasound-Guided Vs Traditional Arterial Cannulation by Emergency Medicine Residents

Introduction: We sought to determine whether ultrasound-guided arterial cannulation (USGAC) is more successful than traditional radial artery cannulation (AC) as performed by emergency medicine (EM) residents with standard ultrasound training.Methods: We identified 60 patients age 18 years or older at a tertiary care, urban academic emergency department who required radial AC for either continuous blood pressure monitoring or frequent blood draws. Patients were randomized to receive radial AC via either USGAC or traditional AC. If there were three unsuccessful attempts, patients were crossed over to the alternative technique. All EM residents underwent standardized, general ultrasound training.Results:The USGAC group required fewer attempts as compared to the traditional AC group (mean 1.3 and 2.0, respectively; p
Source: Western Journal of Emergency Medicine - Category: Emergency Medicine Source Type: research

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CONCLUSION: A procedural performance checklist was created for ultrasound-guided femoral arterial access using the modified Delphi method. This is an objective tool to assist procedural training and competency assessment in a variety of clinical and educational settings. PMID: 32033520 [PubMed - as supplied by publisher]
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
Authors: Derycke L, Mallios A Abstract OBJECTIVE: To report our technique for percutaneous ultrasound-guided retrieval of accidentally transected arterial lines. CASES DESCRIPTION: Two patients are reported herein; in both of these patients, a part of the 20-gauge catheter inserted for invasive monitoring of their blood pressure in the intensive care unit was accidentally transected with part of the catheter remaining in the radial artery. Both patients were initially asymptomatic; therefore, a minimally invasive technique was sought to remove the catheters without inducing significant risk. Under local anesthe...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
Publication date: Available online 25 October 2019Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Lori-Ann Oliver, Jodi-Ann Oliver, Sargis Ohanyan, William Park, Aharon Benelyahoo, Nalini VadiveluPeripheral venous access is perhaps the most commonly performed procedure in hospitals, urgent care, or surgical centers across the country. The ability to obtain peripheral intravenous (IV) access, and in a timely manner, is arguably one of the most important skill sets to be mastered by health care professionals. While skill and experience play a role in successful and timely vascular access, numerous pati...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
AbstractPurpose of ReviewTo explore recent advancements in the use of point-of-care ultrasound in the pediatric intensive care unit or during the perioperative period.Recent FindingsUltrasound is useful for selecting an appropriate endotracheal tube size, predicting postextubation stridor, assessing vocal cord paralysis, performing ultrasound-guided lung recruitment, assessing circulatory volume status, performing transcranial Doppler for assessment of cerebral perfusion, assessing intracranial hypertension, assessing central venous catheter tip position, and performing arterial line cannulation.SummaryThere has been rapid...
Source: Current Pediatrics Reports - Category: Pediatrics Source Type: research
Publication date: Available online 25 October 2019Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Jodi-Ann Oliver, Sargis Ohanyan, William Park, Aharon Benelyahoo, Nalini VadiveluAbstractPeripheral venous access is perhaps the most commonly performed procedure in hospitals, urgent care, or surgical centers across the country. Thus, arguably the ability to obtain peripheral intravenous access in a timely manner is one of the most important skill sets to be mastered by health care professionals. While the skill and experience of a health care professional is an important factor in determining successfu...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
Abstract Arterial catheterization is frequently performed in intensive care units to facilitate hemodynamic monitoring and frequent blood sampling. Overall, arterial catheterization has high success and low complication rates, but in critically ill patients the incidence of failure is higher due to hypotension, peripheral edema, and obesity. Ultrasound guidance significantly increases the likelihood of successful cannulation and decreases complications compared to traditional landmark-based techniques. Multiple ultrasound techniques for radial and femoral arterial catheter insertion have been described; this artic...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
Publication date: Available online 27 August 2019Source: Journal of Pediatric Surgery Case ReportsAuthor(s): Philip Maykowski, Jae-O. Bae, David M. NotricaAbstractThis is a case of a 6-month old female with no prior medical history who presented to the emergency department following a high-speed motor collision with ejection of an improperly installed car seat. The patient was hemodynamically unstable with tachycardia, poor perfusion, and marks from the car seat. A focused assessment with sonography in trauma (FAST) ultrasound exam revealed no intraabdominal fluid, but evidence of cardiac tamponade which was confirmed by c...
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
Recently I've been doing more axillary arterial lines in the ICU. They are much easier to place than radials, have more collateral circulation than brachials, and last way longer than either so it means torturing your patients less. However, one thing that still bugs me about them is that I feel that there is no guaranteed way to avoid the brachial plexus. You can often see the nerve bundles around the artery with ultrasound, but not always that well. And, sometimes, the only way to get to... Avoiding the brachial plexus when placing axillary a-lines
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Anesthesiology Source Type: forums
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 344th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Catch up with the Curbsiders and hear Renee Dversdal talk about her passion for I...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: LITFL review LITFL R/V Source Type: blogs
By ANISH KOKA The phone rings.  It’s not supposed to be ringing.  It’s 2 am.   The voice on the other line is from an apologetic surgery resident. Resident: There is this patient.. Me: Yes, go ahead. Please. Resident: He’s tachycardic. Me: How fast? Resident: 160 ? Me: What’s the blood pressure? Resident: 130/90 Me: Rhythm? Resident: An SVT I think.. I gave adenosine.  Nothing happened Me: Audibly groaning.  I’ll be in.. Forty five minutes later I’m at the bedside of a decidedly ill appearing man. I want to be triumphant that his heart rate is only ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs
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