Central Venous Catheter Confirmation by Ultrasonography: A Novel Instructional Protoco

Tozer, Jordan

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VCU Scholars Compass

Virginia Commonwealth UniversityVCU Scholars CompassMedical Education Symposium School of Medicine2018Central Venous Catheter Confirmation byUltrasonography: A Novel Instructional ProtocolJordan TozerVirginia Commonwealth UniversityFollow this and additional works at: https://scholarscompass.vcu.edu/med_eduPart of the Medicine and Health Sciences Commons© The Author(s)This Poster is brought to you for free and open access by the School of Medicine at VCU Scholars Compass. It has been accepted for inclusion inMedical Education Symposium by an authorized administrator of VCU Scholars Compass. For more information, please contact libcompass@vcu.edu.Downloaded fromhttps://scholarscompass.vcu.edu/med_edu/36Central(Venous(Catheter(Confirmation(by(Ultrasonography:(A(Novel(Instructional(Protocol• A(brief(didactic(session(is(satisfactory(for(dissemination(of(knowledge(regarding(ultrasound(confirmation(for(central(line(placement• Immediate(and(short(term(retention(is(adequate• Participants(highly(satisfied(with(module(and((plan(to(incorporate(skill(into(practice• Future(chart(review(to(study(if(use(of(this(technique(is(occurring(in(practiceConclusions• Multiple(studies(within(last(10(years(examining(feasibility,(speed(and(accuracy(of(ultrasound(for(central(venous(catheter(malposition• Recent((systematic(review(and(metaHanalysis(from(Ablordeppey,(et(al:• Ultrasound(is(fast((2min(vs(58min)• Ultrasound(is(highly(sensitive(and(specific(for(detecting(catheter(malposition• ReHdemonstrates(high(sensitivity(and(specificity(for(detecting(pneumothorax• Should(be(used(as(first(line(CVC(confirmation(technique• Need(for(dissemination(of(technique(to(practitioners(Purpose• 47(EM(physicians(completed(the(online(didactic(session,(24(followed(up(to(complete(the(simulation(testing• All(47(participants(scored(94%(or(greater(on(7(question(post(didactic(quiz(• Demonstrates(adequate(knowledge(acquisition• All(24(participants(scored(100%(accuracy(on(follow(up(simulation(scenarios(2(weeks(later• Various(RASS(timing• Detection(of(PTX(• Demonstrates(short(term(retention• All(participants(“agreed”(or(“strongly(agreed”(that(the(educational(module(improved(their(understanding(of(CVC(confirmation(using(ultrasound(and(“strongly(agreed”(that(they(plan(to(incorporate(this(skill(into(their(clinical(practiceResults• Prospective(educational(cohort(didactic(and(simulation(study,(with(convenience(sample(of(47(EM(residents(and(attendings at(Level(1(academic(trauma(attending• A((((X((((O1(((O2• Online(didactic(session(followed(by(immediate(online(testing• FollowHup(simulation(session(with(testing(within(2(weeks• Focused(on(identification(of(the(rapid(atrial(swirl(sign((RASS)(and(importance(of(timing(from(flush(to(visualization((see(image(D)• <2sec(=(appropriately(placed(CVC• >2sec(=(venously misplaced(CVC• No(RASS(=(not(in(venous(systemMethods• ." FiguresJordan6Tozer6MD,6Michael6Vitto DO,6Michael6Joyce6MD,6Lindsay6Taylor6MD,6David6Evans6MDDepartment*of*Emergency*Medicine,*Ultrasound*Section,*Virginia*Commonwealth*University,*Richmond,*VAConnect'with'VCU'Emergency'Medicineemergencymedicine.vcu.edu @VCUEMVCUEM3ResidencyAB DAbove"the"diagphragm (IJ"and"subclavian)View of"vein"of"interest"collapsing"View(of(guidewire(in(vesselSubxiphoidbubble"study"(must"reach"RA"<2secs)Clip"of"ipsilateral"sliding"lungsCVC"safe"for"useFemoralView of"vein"of"interest"collapsing"View(of(guidewire(in(vesselSubxiphoidbubble"study"(must"reach"RA"<3secs)CVC"safe"for"use

Central Venous Catheter Confirmation by Ultrasonography: A Novel Instructional Protocol

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Central Venous Catheter Confirmation by Ultrasonography: A Novel Instructional Protocol

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