Needle guides for venous cathether insertion during chest compressions: A crossover simulation trial

• Published in: The American journal of emergency medicine 2016
• Main Authors: Cho, Takashi, Komasawa, Nobuyasu, Haba, Masanori, Fujiwara, Shunsuke, Mihara, Ryosuke, Minami, Toshiaki
• Format: Article
• Language: English
• Subjects: Emergency
• ISSN: 0735-6757
• DOI: 10.1016/j.ajem.2016.02.036

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 two 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 min, insertion time, and subjective difficulty of venous puncture or guide-wire insertion were measured. Results In normal trials, one participant failed US-CVC without compressions, while six failed with compressions (P = .04). In needle guided trials, all participants succeeded without compressions, while only one failed with compressions (P = .31). Intubation time was significantly longer with chest compressions in both normal and needle guided trials ( P < .001, each). US-CVC insertion time in normal trials was significantly longer than in needle guided trials with compressions ( P < .001). Difficulty of operation on a visual analogue scale (VAS) for venous puncture or guidewire 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.