Ultrasound-Guided Subclavian Venipuncture is More Rapidly Learned than the Anatomic Landmark Technique in Simulation Training

Tokumine, Joho; Matsushima, Hisao; Lefor, Alan Kawarai; Igarashi, Hiroshi; Ono, Katsushige

doi:10.5301/jva.5000318

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…Our study further corroborated the effectiveness of CCUS through models/simulations, strengthening training effects, and promoting the widespread application of bedside ultrasound. Traditional teaching relies mainly on instructor lectures, with students learning via textbooks and notes and then practicing on existing patients, which is a highly random process [20]. In contrast, simulation protects patient safety and rights, reducing hospital-acquired infection risk from repeated student practice.…”

Section: Discussionmentioning

confidence: 99%

Specialized critical care ultrasound training in critical care medicine education: a prospective single-center observational study with pre-post evaluations

Hui,

Shanshan,

Yongyi

et al. 2024

Preprint

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Background The widespread use of critical care ultrasound (CCUS) for the management of patients in intensive care units (ICUs) requires effective training. The effectiveness of long-term, specialized CCUS training courses is unclear. This study describes a simulation-based, 6-month CCUS training program and evaluates its efficacy. Methods Seven consecutive CCUS courses, totaling 164 participants, were studied. The 6-month CCUS training comprised didactic lectures, pathological image interpretation, hands-on modules with stimulators/live models, and clinical CCUS use, including performing CCUS on needed patients and case analysis. Echocardiography and pulmonary, renal, vascular and craniocerebral ultrasound were performed. Satisfaction, theoretical/operational performance, comprehensive ultrasound application in clinical practice, and the influence of ultrasound training on clinical outcomes were assessed pre- and post-training by the Kirkpatrick Level 4 Model. Results More than 90% of the trainees reported “agree” or “strongly agree” to all survey questions. After ultrasound training, all the trainees significantly improved their theoretical examination, abnormal image interpretation and operational skills (all P < 0.05). The trainees' practical ultrasound application ability significantly improved (case assessment: 76 (72, 84) vs. 48 (38, 55); case analysis score: 21 (17, 26) vs. 11 (8, 15); image interpretation: 16 (13, 18) vs. 4 (2,7); all P < 0.05). Of 956 CCUSs, 415 yielded new diagnoses, 374 confirmed previous diagnoses, and treatment changes were made, impacting clinical decision-making by 82.53%. Conclusions Learners demonstrated significant improvements in the theoretical knowledge and practical skills of CCUS. In addition, they demonstrated clinical application ability, as evidenced by their high case analysis ability. This 6-month course is an effective method for training critical care clinicians in the skills requisite and clinical application of CCUS.

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Section: Discussionmentioning

confidence: 99%

Specialized critical care ultrasound training in critical care medicine education: a prospective single-center observational study with pre-post evaluations

Hui,

Shanshan,

Yongyi

et al. 2024

Preprint

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“…The value of simulation education in learning the technique of ultrasound‐guided placement of central venous catheters has been shown in simulation studies . In fact, it has been shown that the ultrasound guided technique is easier for trainees to learn than the anatomical landmark method, through simulation studies …”

Section: Simulation Education In Acute Medicine and Surgerymentioning

confidence: 99%

Trauma surgery simulation education in Japan: the Advanced Trauma Operative Management course

Lefor

2018

Acute Medicine & Surgery

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Simulation has become an important teaching tool, in part because of changes mandated by restrictions in resident work hours. Simulation models include life‐like mannequins, ex vivo tissue, cadavers, and live animal models. The Advanced Trauma Operative Management (ATOM) course teaches a standard approach for the treatment of traumatic injuries. The 1‐day course includes six lectures in the morning and a live animal surgery laboratory in the afternoon. The animal laboratory includes five standard injury scenarios. Advanced Trauma Operative Management was brought to Japan in 2008 and has carried out 60 courses, training more than 250 surgeons and 70 instructors at six training sites throughout Japan. There have been a number of innovations initiated by ATOM Japan including Nurse Participation Certificates and a course for Trauma Nurses that runs concurrently with the ATOM course. There are other trauma courses given throughout the world, which are scenario‐based and include concurrent nurse training. It is difficult to quantitatively assess the benefits of trauma training to patients. There are a number of documented cases in Japan of surgeons who have had good operative outcomes in the care of traumatically injured patients who attribute the successful management of these patients to participation in the ATOM course. Training in trauma surgery using simulation models and the ATOM course have had a positive impact on surgical training and patient care in Japan. These courses will continue to be modified and refined, resulting in better education and clinical outcomes. Education research is essential to determine the optimum use of the available models.

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“… 21 This approach offers a shorter, more direct course to the SCV, traversing only fascial planes, whereas with an infraclavicular approach, it must traverse the pectoralis major muscle, which may lead to increased catheter malpositioning. 22 , 23 In a randomized prospective comparative study of infraclavicular vs. supraclavicular approaches using a LM technique, there was a 9% incidence of catheter malpositioning in the infraclavicular group compared to 0.5% in the supraclavicular group. 22 In another prospective comparative study evaluating 144 patients requiring central venous catheterization, a supraclavicular approach had a statistically significant higher success rate in comparison to an infraclavicular approach.…”

Section: Supraclavicular Subclavian Vein Cannulation Under Ultrasoundmentioning

confidence: 99%

“…In a study by Tokumine et al, 20 medical trainees received instruction on both LM and US-guided SCV cannulation using the longitudinal axis. 23 Sufficient skill to place an US-guided SCV catheter was achieved with three attempts compared to nine for the LM technique.…”

Section: Infraclavicular Subclavian Cannulation Under Ultrasound Guidmentioning

confidence: 99%

Ultrasound-Guided Cannulation: Time to Bring Subclavian Central Lines Back

Rezayat¹,

Stowell²,

Kendall³

et al. 2016

WestJEM

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Despite multiple advantages, subclavian vein (SCV) cannulation via the traditional landmark approach has become less used in comparison to ultrasound (US) guided internal jugular catheterization due to a higher rate of mechanical complications. A growing body of evidence indicates that SCV catheterization with real-time US guidance can be accomplished safely and efficiently. While several cannulation approaches with real-time US guidance have been described, available literature suggests that the infraclavicular, longitudinal “in-plane” technique may be preferred. This approach allows for direct visualization of needle advancement, which reduces risk of complications and improves successful placement. Infraclavicular SCV cannulation requires simultaneous use of US during needle advancement, but for an inexperienced operator, it is more easily learned compared to the traditional landmark approach. In this article, we review the evidence supporting the use of US guidance for SCV catheterization and discuss technical aspects of the procedure itself.

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Ultrasound-Guided Subclavian Venipuncture is More Rapidly Learned than the Anatomic Landmark Technique in Simulation Training

Abstract: US-SV was learned more quickly than LM-SV in a simulation model.

Cited by 10 publications

References 16 publications

Specialized critical care ultrasound training in critical care medicine education: a prospective single-center observational study with pre-post evaluations

Specialized critical care ultrasound training in critical care medicine education: a prospective single-center observational study with pre-post evaluations

Trauma surgery simulation education in Japan: the Advanced Trauma Operative Management course

Ultrasound-Guided Cannulation: Time to Bring Subclavian Central Lines Back

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