The authors describe an outbreak of Burkholderia cenocepacia bacteremia in 4 hospitals across Australia between the dates of March 2017 and May 2017. Eleven patients were infected, predominately in intensive care units. A collaborative outbreak response team was formed to investigate sources of the contamination. Intravenous fluids were cultured and testing of multiple potential sources were performed. The source of the infection was traced back to contaminated sterile ultrasound gel sachets within kits used in central line insertion and sterile procedures.
Why is it so important to practice sterile technique during vascular access procedures as a part of the overall infection control protocol in ultrasound? Before we help answer that question,… read more →
When ultrasound is used for point-of-care needle guided procedures, including vascular access or regional anesthesia, it is recommended by the FDA and the CDC that a single-use, disposable probe cover… read more →
Ultrasound guided insertion is recommended for all routes of central venous catheterization. Make ultrasound needle guidance the standard of care in your facility for improved needle visualization, increased first-time success rates, and reduced complications – resulting in increased patient safety and shorter procedure times for all users.
This study tested the hypothesis that a needle guided technique (NG) would allow faster central venous catheter placement, better success rates and fewer needle sticks than both the short-axis (S-FH) and long-axis (L-FH) free-handed methods. Additionally, the authors postulated the lack of control of needle depth under the short-axis (S-FH) approach contributes to inadvertent arterial puncture.
A clinical study approved by the Chiba Medical Center Ethical Committee was performed to test a three-step method designed to overcome pitfalls associated with ultrasound-guided long-axis central vein catheterization (LAX-IP). Identified pitfalls of this technique include veins that curve and are challenging to approach, utilizing free-hand needling technique requires specific skills and training and lastly, identifying the true center of the view in LAX-IP is challenging with 2D imaging.
The authors conducted the first clinical, prospective, randomized trial of ultrasound-guided subclavian vein cannulation for central venous catheterization with an in-plane multi-angle needle guide (Infiniti Plus, CIVCO, Kalona, IA). This study was approved by the Ethics Committee of the Faculty of Medicine of Ruhr University, Bochum, Germany and includes analyzed results from 159 catheterizations.
Trial participants consisted of 25 anesthesiologists with more than 2 years of clinical experience and/or who received simulation training at the author’s institutions. All participants had received prior simulation-based CVC training. Simulation trial equipment consisted of: CVC simulator, SonoSite iLook ultrasound machine using the L25 (5-10 MHz) linear transducer and with the Infiniti™ Needle Guidance System (CIVCO Medical Solutions, Kalona, Iowa) attached to the transducer.