Training the Trainers in Ultrasound-guided Access to Improve Peripheral Intravenous Catheter Placement Among Children Presenting for Anesthesia

Overview

Journal Pediatr Qual Saf

Date 2021 May 12

PMID 33977194

Citations 3

Authors

Vikas N OReilly-Shah

Amber Franz

Cornelius B Groenewald

Michael Collins

Lance S Patak

Affiliations

Soon will be listed here.

Abstract

Methods: We implemented an evidence-based difficult IV algorithm and ultrasound-guided PIV placement training for attending pediatric anesthesiologists at a tertiary academic pediatric institution. The algorithm outlined risk factors for difficult IV access, established a goal of 3 or fewer attempts, and recommended early ultrasound use after 1 unanticipated attempt and the first attempt for anticipated difficult IV. Group sessions, including instruction and simulated practice, preceded a period of individual training in the operating room using a punch card to monitor each trainee's progress while also serving to motivate continued engagement.

Results: We performed a cross-sectional analysis of consecutive cases from December 1, 2015, to September 30, 2019, comparing a 22-month baseline period (n = 12,581) with the training period (n = 6,725) and the following year (n = 6,557). Cases requiring more than 3 attempts decreased from 4.0% to 2.7% overall and from 10% to 6.2% among patients 24 months or less of age. The time required to establish PIV access was unchanged. Factors associated with increased attempts were identified.

Conclusions: Implementing a difficult IV algorithm and training among attending pediatric anesthesiologists in ultrasound-guided PIV placement reduced attempts but not the time required to establish PIV access.

Citing Articles

Smart Glasses to Facilitate Ultrasound Guided Peripheral Intravenous Access in the Simulation Setting for Thai Emergency Medical Service Providers.

Ienghong K, Cheung L, Wongwan P, Apiratwarakul K J Multidiscip Healthc. 2023; 16:2201-2206.

PMID: 37547807 PMC: 10404035. DOI: 10.2147/JMDH.S424487.

A comparison of first-attempt cannulation success of peripheral venous catheter systems with and without wings and injection ports in surgical patients-a randomized trial.

Morgeli R, Schmidt K, Neumann T, Kruppa J, Fohring U, Hofmann P BMC Anesthesiol. 2022; 22(1):88.

PMID: 35361115 PMC: 8969381. DOI: 10.1186/s12871-022-01631-7.

Clinical and demographic factors associated with pediatric difficult intravenous access in the operating room.

Ballard H, Hajduk J, Cheon E, King M, Barsuk J Paediatr Anaesth. 2022; 32(7):792-800.

PMID: 35293066 PMC: 9310763. DOI: 10.1111/pan.14438.

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