Teaching Ultrasound Imaging for Central Line Placement—A Resident’s Perspective

Jayanta Mukherji, Nil Ural, Taqdees Sheikh, W. Scott Jellish

Loyola University Medical Center, Anesthesiology, Maywood, USA..

DOI: 10.4236/ojanes.2013.35058                

Abstract

The availability of ultrasound (US) devices has refined techniques for vascular access. The resident trainee’s ability to learn US techniques depends upon device availability, skills, and motivation of instructors. We hypothesized that hands-on teaching program of US techniques for vascular access would have a positive impact on the trainee’s perceptions. After IRB approval, PGY3 anesthesiology residents with limited prior experience in US-guided vascular access underwent close supervision by attending staff as they performed US-guided Internal Jugular Vein (IJV) central line placements. A total of 66 land mark (LM) and 75 US-guided IJV cannulation performed by 19 residents were supervised. Residents completing the study were more proactive with 68.4% agreeing to use US based techniques for an anticipated difficulty in accessing central lines. The graduating residents involved in the study all strongly agreed that US imaging for vascular access was within the scope of practice of all anesthesiologists, and that training guidelines be established and incorporated in their practice. Fifty eight percent of residents stated that their confidence and skill levels had significantly improved. Teaching US-guided techniques resulted in an increase employment of such techniques by graduating residents with no impediment attributed to knowledge deficits or inexperience. Residents were more proactive with using US for anticipated difficulty in IJV placement. A short neck, poor landmark, anticoagulation, morbid obesity favored US use by residents. Systematic teaching of US techniques is justified as it significantly improves the resident’s perceptions and confidence.

Keywords

Ultrasound-Guided Technique; Vascular Access; Guidelines; Resident’s Perception

Conflicts of Interest

The authors declare no conflicts of interest.

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