Training novice in ultrasound-guided venipuncture: A randomized controlled trial comparing out-of-plane needle-guided versus free-hand ultrasound techniques on a simulator
Training novice in ultrasound-guided venipuncture: A randomized controlled trial comparing out-of-plane needle-guided versus free-hand ultrasound techniques on a simulator
复制标题
DOI：
10.1177/1129729820962916
复制
发表时间：
2020-10-08
影响因子：
1.9
通讯作者：
Bouaziz, Herve
中科院分区：
文献类型：
--
作者：
Raft, Julien;Dupanloup, Daniele;Bouaziz, Herve
背景：外周静脉途径是一种常见的医疗程序，但在一些患者中可能很难执行。事实证明，在超声引导下，成功率更高。使用超声波的外周静脉途径需要专门的培训，特别是对于新的超声波使用者。为了克服这些困难，超声探头上的引导装置能够控制穿透组织的角度。我们假设，尤其是对于新的超声使用者，使用针导(NG)配合平面外方法将比类似的自由手(FH)技术更有效地促进血管模拟模型的穿刺术。方法：在明胶模体上使用导丝导引针，对新的超声使用者进行前瞻性随机对照研究。在30分钟的讲座后，一组人进行了FH技术，另一组人进行了NG技术，这两种方法都是平面外方法。主要的标准是在这种模型的血管插管成功之前尝试的次数。结果：34名麻醉师护生参与研究。使用NG技术成功前的尝试次数显著减少：NG组3.7次(+/-0.9)，FH组6.7次(+/-3.3)(p=0.01)。在NG组，在第六次尝试后，100%的参与者成功。FH组成功率为81.25%(n=13/16)。结论：NG技术较FH技术具有更陡峭的学习曲线。需要对临床实践中的学习曲线进行研究才能证实这些结果。
Background: Peripheral intravenous access is a common medical procedure, however, it can be difficult to perform in some patients. Success rates have proved greater with ultrasound guidance. Peripheral intravenous access using ultrasound requires specific training, especially for new ultrasound users. To overcome these difficulties, guidance devices on ultrasound probes are able to control the angle of penetration into tissues. We hypothesized that, and particularly for new ultrasound users, the use of a needle guide (NG) paired with the out-of-plane approach would facilitate puncture of a simulation model of vessel more effectively than similar free hand (FH) techniques. Methods: A prospective controlled randomized study was conducted of new ultrasound users using a guide wire introducer needle on gelatine phantom. After a 30-min lecture, one group performed the FH technique and the other group performed the NG technique both in an out-of-plane approach. The main criterion was the number of attempts before success of catheterization of this model of vessel. Results: Thirty-four nurse anesthetist students participated in the study. The number of attempts before success using the NG technique was significantly lower: 3.7 (+/- 0.9) in the NG group versus 6.7 (+/- 3.3) in the FH group (p = 0.01). In the NG group, 100% of the participants achieved success after the sixth attempt. In the FH group, only 81.25% (n = 13/16) reached success. Conclusion: NG technique has been proved to have a steeper learning curve compared with the FH technique. A study on a learning curve in clinical practice is needed to confirm these results.