Introducing ultrasound-guided vein catheterization into clinical practice: A step-by-step guide for organizing a hands-on training program with inexpensive handmade models

Abstract

KEYWORDSCentral vein catheterization; Ultrasound; Handmade models; Training.Abstract Introduction: Central vein catheterization (CVC) plays a central role in hospital patient management. Compared with the use of traditional anatomical landmarks, ultrasound-guidance is associated with higher CVC success rates, fewer complications, and more rapid central venous access. The use of US-guided CVC in clinical practice has not become widespread, largely because anesthesiology and general surgery residents receive limited training in this technique. To increase the use of US-guided CVC in our surgical department, we organized a hands-on training program based on the use of handmade models. Methods: Three different models were constructed using plastic food-storage containers, segments of rubber tourniquet and silastic tubing (to simulate vessels), and agar gelatin. Results: The hands-on training course allowed progressive acquisition of the basic handeeye coordination skills necessary for performing US-guided venipuncture. The overall cost for each model was less than V5.00. Discussion: The models described in this report are useful tools for teaching US-guided CVC. Thanks to their low-cost, they can be widely used to facilitate the introduction of this technique in clinical practice.Sommario Introduzione: Il catetererismo venoso centrale (CVC) riveste un ruolo fondamentale nella gestione del paziente ospedalizzato. La tecnica eco-guidata è la metodica che assicura una più elevata percentuale di successo e permette un più sicuro e rapido posizionamento di CVC rispetto alla tecnica tradizionale. Tuttavia, la diffusione di tale metodica è ostacolata dall'assenza di uno specifico training durante i corsi di specializzazione in anestesia e chirurgia.Al fine di introdurre la tecnica eco-guidata, abbiamo organizzato un training producendo e utilizzando modelli in agar. Metodi: Sono stati costruiti tre differenti modelli utilizzando contenitori per alimenti, segmenti di laccio emostatico, tubo in silicone e gelatina a base di agar. Risultati: Un training specifico per la puntura eco-guidata è stato effettuato utilizzando i modelli prodotti. Il training ha consentito una rapida acquisizione delle basi tecniche per effettuare il posizionamento di CVC eco-guidato. Il costo medio di ogni modello è risultato inferiore a 5 euro. Discussione: I modelli prodotti in agar si sono rivelati un utile strumento per acquisire la coordinazione di base necessaria per la puntura eco-guidata. Il loro basso costo ne può permettere una ampia diffusione e può incentivare la realizzazione di nuovi percorsi educativi al fine di introdurre tale tecnica nella pratica clinica. ªa v a i l a b l e a t w w w . s c i e n c e d i r e c t . c

Efficacy Evaluation of a non-human experimental model for ultrasound-guided superficial venous puncture: clinical randomized assay

“…These data suggest that the use of a low-cost, nonhuman model with a current value of R $ 8.00 (around $2,50) , similar to the equivalent values found in the literature ranging from US $ 3.00 to US $ 22.83 34,36,37 or around € 24,00 38 , together with an easily reproducible training methodology, showed better technique results without complications, reinforcing that simulator training increases the rates of success by improving the technique and increasing the professional experience 8,38 regardless of the financial conditions of the institutions.…”

Ultrasound guidance for internal jugular vein cannulation in PICU: a randomised controlled trial

“…During the practical training, the residents received instructions on the operation of the US device and were able to perform punctures on a handmade model that had been produced according to the instructions by Domenico et al (model A) 15. Then, each resident was trained in the use of the US guidance technique in five cases that were not related to this study.…”

Agar ultrasound phantoms for low-cost training without refrigeration

“…However, most homemade phantoms lack durability and many are made of perishable materials that can only be kept for a short time before spoiling. 7 , 8 , 9 , 10 , 11 , 12 …”