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A WINning Technique: The Wire-in-Needle Feasibility Study.

Torben K Becker¹, Joseph A Betcher¹, Suzanne L Dooley-Hash¹

¹Department of Emergency Medicine, University of Michigan Health System, Ann Arbor, Michigan.

The Journal of Emergency Medicine

|August 19, 2015

Summary

The wire-in-needle (WIN) technique for central venous catheter placement is safe and effective. Clinicians can quickly learn this method, which offers faster cannulation times and improved guidewire accuracy compared to traditional approaches.

Keywords:

Seldinger technique central line central venous catheter procedural safety ultrasound

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Area of Science:

Medical Devices
Ultrasound Technology
Surgical Techniques

Background:

Dynamic ultrasound guidance enhances central venous catheter placement safety.
Hypotensive patients present unique challenges for central venous cannulation.
The wire-in-needle (WIN) technique offers a novel approach to increase procedural safety.

Purpose of the Study:

To evaluate the feasibility and safety of the WIN technique for central venous catheter placement.
To compare the WIN technique with the traditional method in terms of speed and accuracy.

Main Methods:

Sixty clinicians (medical students, residents, attending physicians) participated.
Participants received training on the WIN technique followed by a skills assessment.
A survey assessed prior ultrasound experience and perceptions of the WIN technique.

Main Results:

The WIN technique was significantly faster than the traditional method (45.9 vs. 61.5 s).
Accurate guidewire positioning in the vein was confirmed more frequently with the WIN technique (95% vs. 75%).
No significant differences were observed in needle redirections, cannulation attempts, or arterial punctures.

Conclusions:

The WIN technique is easily and quickly learned by clinicians across different training levels.
The WIN technique demonstrated comparable safety and success rates to the traditional approach in manikin studies.
Over 90% of participants met safety criteria, with most planning to adopt the WIN technique in practice.