Needle guides for venous catheter insertion during chest compressions: a crossover simulation trial

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Abstract

Purpose:

Recent guidelines for cardiopulmonary resuscitation emphasize that all rescuers should minimize the interruption of chest compressions, even for intravenous access. We assessed the utility of needle guides during ultrasound-guided central venous catheterization (US-CVC) with chest compressions via simulation.

Methods:

Twenty-five anesthesiologists with more than 2 years of experience performed US-CVC on a manikin with or without a needle guide and with or without chest compressions. Insertion success rate within 2 minutes, insertion time, and subjective difficulty of venous puncture or guide wire insertion were measured.

Results:

In normal trials, 1 participant failed US-CVC without compressions, whereas 6 failed with compressions (P = .04). In needle-guided trials, all participants succeeded without compressions, whereas only 1 failed with compressions (P = .31). Insertion time was significantly longer with chest compressions in both normal and needle-guided trials (P < .001, each). Ultrasound-guided central venous catheterization insertion time in normal trials was significantly longer than in needle-guided trials with compressions (P < .001). Difficulty of operation on a visual analog scale for venous puncture or guide wire insertion was significantly higher in normal trials than in needle-guided trials with compressions.

Conclusion:

Needle guides shortened the insertion time and improved the success rate of US-CVC during chest compressions by anesthesiologists in simulations.

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