Needle guides for venous catheter insertion during chest compressions: a crossover simulation trial

Recent guidelines for cardiopulmonary resuscitation emphasize that all rescuers should minimize the interruption of chest compressions, even for intravenous access. We assessed the utility of needle guides during ultrasound-guided central venous catheterization (US-CVC) with chest compressions via simulation.

Twenty-five anesthesiologists with more than 2years of experience performed US-CVC on a manikin with or without a needle guide and with or without chest compressions. Insertion success rate within 2minutes, insertion time, and subjective difficulty of venous puncture or guide wire insertion were measured.

In normal trials, 1 participant failed US-CVC without compressions, whereas 6 failed with compressions (P=.04). In needle-guided trials, all participants succeeded without compressions, whereas only 1 failed with compressions (P=.31). Insertion time was significantly longer with chest compressions in both normal and needle-guided trials (P<.001, each). Ultrasound-guided central venous catheterization insertion time in normal trials was significantly longer than in needle-guided trials with compressions (P<.001). Difficulty of operation on a visual analog scale for venous puncture or guide wire insertion was significantly higher in normal trials than in needle-guided trials with compressions.

Needle guides shortened the insertion time and improved the success rate of US-CVC during chest compressions by anesthesiologists in simulations.