PP353 [Quality and Safety » Improvement huddles]: CHEST X-RAY FREE PLACEMENT OF CENTRAL VENOUS CATHETERS: WHERE ARE WE? A WORLD-WIDE SURVEY

Abstract

BACKGROUND AND AIM:It is common standard to request a chest x-ray before using a central venous catheter (CVC). In the last 10 years, the need to keep this practice in asymptomatic patients has been questioned. METHOD:A web-based cross-sectional survey (SurveyMonkey®) on pediatric CVC placement was created to evaluate different habits across the globe and it was spread through social networks, email, or direct messages.RESULTS: 396 answers were received. Europe accounted for 35% (n=140) of them, Latin America for 42% (n=167), North America for 12,8% (n=51), Asia for 7,5% (n=30), Africa for 1,7% (n=7) and Oceania for 0,2% (n=1). Ultrasound(US)-guided CVC placement is used in most cases world-wide (66,6%); 33,3% of respondents practice landmark technique. US is more widespread in North America (94%), Europe (85%) and Asia (66%), while it is less commonly used in Africa (42%) and Latin America (41%).To check tip's position, chest x-ray is requested by 96% of professionals in North America, 93% in Asia, 85% in Africa, 84% in Latin America and 72% in Europe. Intracavitary EKG is used only by 13.5% (19/140) of professionals in Europe, 16% (5/30) in Asia, 2,3% (4/167) in Latin America, and echocardiography is performed by 45% (63/140) of professionals in Europe, 30% (9/30) in Asia, 23% (39/167) in Latin America, 14% (1/7) in Africa and only by 5.8% (3/51) in North America.CONCLUSIONS: Despite performing US-guided CVC placement, 79,9% of professionals still relate to chest-x ray to check tip's position (n=173, 85%) or to exclude complications (n=104, 51%