In our institute of oncology the idea of standardization of introduction of central venous catheter was enacted. So we are searching useful information whether the Ultrasound guidance for CVC in hospitals is obligatory or not? If it's obligatory under what condition anesthesiologist could use the Ultrasound for induction of CVC? Is there a condition:
- of special course for the use of ultrasound?
- how many inductions should be done before the MD is recognized capable to work alone for such inductions?
- are there obligatory courses for the use of ultrasound or depends it on the will of each MD?
- do you have any links to such standards?
And additional: Do you have in your hospital standards that in the case of misinduction of the CVC in carotide artery that such catheters should be removed by vascular surgeons or by use of pull and press?
Thank you for your answers.
Hello,
the French Society of Anesthesiology just published recommendations in the way to use ultrasound guidance for cvc. Today it is not obligatory to use ultrasound guidance for cvc in my hospital. Personally, I use ultrasound guidance for all my cvc. I was formed in another hopital where this technic was broadly used before to use it alone.
Bye
Thank you very much for your answer. I think for v. jugularis interna it is very usefull. We have to start to use ultrasound more.
Best regards!
I have seen serious complications of 'experienced anesthesiologists' after inserting CVCs in the internal jugular vein following the landmarks. Life threatening hemothorax from perforation of the anonymous vein, pneumothorax, and also from inadvert cannulation of the carotid artery one patient dying. May be it hasn't been proven by enough RCTs, but it is my firm belief that these complications will be avoided if the procedure is done by a professional who has been properly trained in sonoscopic recognition and cannulation of these vessels. Don't forget that these cannulations frequently are asked for in patients who are desperately ill and in whom even some rather 'minor' complications might result in death.
Thank you for quick answer. I fully agree with your conclusions. Also my belief is that the use of ultrasound in these procedures is safer. The main problem is training and the availability of appropriate ultrasound in operation rooms. It also take more time at the begining that the blind method.
The Danish Society of Anaesthesiology recommends the use og ultrasound guidence during CVC inserting, but it is not obligatory.
During specialist training all young doctors have a course in FATE, vascular - and nerve block technique. So alle younger specialists in anesthesiology are using ultrasound guidence.
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