Background: Ultrasound-guided vein cannulation is an essential skill in emergency medicine. Prohibitive costs of commercial ultrasound phantoms limit the ability to adequately train residents. We assess the clinical utility of homemade phantoms for medical education.
Methods: Eighteen emergency medicine residents each performed 10 ultrasound-guided IV attempts on patients, half of the attempts before and half after a training course using two homemade ultrasound phantoms with 14 total Penrose drains. We conducted a prospective feasibility study using pre- and post-training surveys comparing confidence and success rates of IV cannulation attempts on patients.
Results: Residents demonstrated an improvement in successful ultrasound-guided peripheral vein cannulations from an average of 47.8% during the first five attempts to 71.1% in the last five attempts. No benefit was noted from the first to the fifth attempts, nor from the six to the tenth attempts, suggesting minimal benefit from experience early on. Residents reported increased confidence in performing ultrasound-guided venous cannulation on patients, identifying the correct probe, adjusting gain and depth, visualizing veins in short and long axis, differentiating arteries from veins, and vein cannulation on a phantom model.
Conclusion: Homemade ultrasound phantoms are cost effective, increase confidence, and improve emergency medicine residents' ability to perform ultrasound-guided vein cannulation.
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http://dx.doi.org/10.14744/tjtes.2022.74712 | DOI Listing |
Gen Thorac Cardiovasc Surg Cases
January 2025
Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-Ku, Osaka, 545-8585, Japan.
Background: Repair of the regurgitant bicuspid aortic valve is an attractive alternative to valve replacement. Although good long-term outcomes have been reported, postoperative aortic stenosis remains a major late cause of repair failure in bicuspid aortic valves. Sinus plication is effective for creating a more symmetrical commissural angle, leading to a decrease in the mean transvalvular pressure gradient.
View Article and Find Full Text PDFJ Clin Exp Hepatol
November 2024
Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India.
Suspicion of vascular injury during endoscopic retrograde cholangiopancreatography (ERCP) should be raised in the event of intraprocedural bleeding, persistent hyperbilirubinemia, and sepsis despite biliary stenting. Most inadvertent portal vein (PV) cannulations during ERCP are innocuous, and mere withdrawal of guidewire and catheter suffices. However, unintentional PV stenting, particularly with larger metallic stents, increases the likelihood of significant bleeding.
View Article and Find Full Text PDFJ Clin Med
December 2024
Anesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany.
Mediastinal mass syndrome represents a major threat to respiratory and cardiovascular integrity, with difficult evidence-based risk stratification for interdisciplinary management. We conducted a narrative review concerning risk stratification and difficult airway management of patients presenting with a large mediastinal mass. This is supplemented by a case report illustrating our individual approach for a patient presenting with a subtotal tracheal stenosis due to a large cyst of the thyroid gland.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
The formula-based estimation of the right internal jugular venous (IJV) catheterization depth can be inaccurate when using ultrasound guidance. External landmark-based and radiological landmark-based methods have been proposed as alternatives to estimate the insertion depth. This study aimed to evaluate these methods using transesophageal echocardiography (TEE)-guided insertion depth as the reference.
View Article and Find Full Text PDFInt J Nurs Stud
December 2024
Service de Médecine Interne, Centre National de Référence des Syndromes Drépanocytaires Majeurs de l'Adulte, AP-HP, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, 20 rue Leblanc, F-75908 Paris cedex 15, France; Service d'aval des urgences, hopital Henri-Mondor Assistance Publique-Hôpitaux de Paris, 1 rue Gustave Eiffeil, 94000 Créteil, France; Université Paris Cité, Paris, France. Electronic address:
Background: Intravenous (IV) access is often required for the treatment of vaso-occlusive crises in patients with sickle cell disease, but can be particularly challenging due to recurrent venous damage. The AccuVein® device, uses near-infrared light technology to visualise veins for easier venepuncture.
Methods: A randomised, controlled trial of the efficacy of the AccuVeinAV400® device in the replacement of peripheral venous lines during a vaso-occlusive crisis was conducted at two centres in France.
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