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Related Experiment Video

Updated: May 1, 2026

A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
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Does a novel method of PICC insertion improve safety?

Jona Caparas1, Jian Ping Hu, Hwei-San Hung

  • 1In the infection control department at New York Hospital Queens in Flushing, N.Y., Jona Caparas is the IV/PICC team coordinator and Jian Ping Hu and Hwei-San Hung are PICC nurses. Ms. Caparas is also the president of the Association for Vascular Access New York Metro Network.

Nursing
|April 16, 2014
PubMed
Summary

The accelerated Seldinger technique (AST) is faster and safer for peripherally inserted central catheter (PICC) insertion than the modified Seldinger technique (MST). AST reduces blood loss and sharps exposure, benefiting both patients and healthcare workers.

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Area of Science:

  • Medical Devices
  • Vascular Access Procedures
  • Interventional Cardiology

Background:

  • Central venous access device insertion via internal jugular or subclavian veins carries significant risks.
  • Patient and healthcare worker safety are paramount during invasive procedures.

Purpose of the Study:

  • To compare the safety and efficacy of the accelerated Seldinger technique (AST) versus the modified Seldinger technique (MST) for peripherally inserted central catheter (PICC) insertion.
  • To determine if AST offers significant safety advantages over MST in PICC placement.

Main Methods:

  • A randomized, prospective study design was employed.
  • Patients were assigned to either MST or AST for introducer sheath insertion.
  • Key outcome measures included time to completion, blood loss, success rate, vessel-to-air exposure, and sharps exposure.

Main Results:

  • Both AST and MST demonstrated equivalent success rates for vessel cannulation.
  • AST was significantly faster than MST (P = 0.0048).
  • AST resulted in significantly less blood loss (P = 0.0295), fewer vessel-to-air exposures (P < 0.0001), and fewer unprotected sharps exposures (P < 0.0001).

Conclusions:

  • The accelerated Seldinger technique (AST) is a faster and safer method for PICC peelable introducer sheath insertion compared to the modified Seldinger technique (MST).
  • AST offers significant safety benefits for both patients and healthcare workers by reducing complications.
  • Despite a small, unblinded study size, results show high statistical significance, supporting AST's advantages.