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Paediatric ultrasound-guided vascular access: Experiences and outcomes from an emergency department educational
Trent Calcutt1, Robyn Brady1, Kong Liew1
1Department of Emergency Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia.
Insights
A brief ultrasound-guided vascular access education package for pediatric emergency staff is feasible. Motivated trainees achieved higher competency, improving ultrasound-guided IV access success rates.
Area of Science:
- Medical Education
- Emergency Medicine
- Vascular Access
Background:
- Ultrasound-guided vascular access is crucial in pediatric emergency departments.
- Effective training strategies are needed to improve clinician proficiency.
- Difficult intravenous access is common in pediatric patients.
Purpose of the Study:
- To describe the implementation of an ultrasound-guided vascular access education package for pediatric emergency staff.
- To assess clinician and departmental responses to the educational intervention.
- To inform future effective education provision for vascular access.
Main Methods:
- A quality assurance project involving opt-in emergency department staff.
- A multi-phase educational package: theory, practical (90-120 min), and procedural supervision.
- Data collected via de-identified surveys and logbooks.
Main Results:
- 23 staff trained; 78.3% had no prior successful ultrasound-guided cannulae.
- 15 weeks post-training, 28.6% reached competency; 61.9% placed at least one cannula.
- Ultrasound-guided IV access attempts increased from 11.0% to 81.8% post-intervention.
Conclusions:
- A low-resource, brief ultrasound-guided vascular access education is achievable.
- Barriers to education uptake were identified.
- Targeting highly motivated trainees yielded the best competency acquisition.
Aim:
This quality assurance project aims to describe the provision of an ultrasound-guided vascular access education package to paediatric emergency department staff. It subsequently aims to measure clinician and departmental responses to this educational intervention to support future effective education provision.
Methods:
Participants were opt-in emergency department staff. Staff were required to be approved to insert intravenous cannulae in the department. A minimum of 50% were non-rotational staff. The educational package consisted of a theory phase (pre-learning video, information document), a practical phase (intensive 90-120 minute individualised session using a mix of live subjects/training equipment), and an embedding phase (education group available for procedural supervision). Data collection was via de-identified, encoded self-reported survey data and logbooks.
Results:
Twenty-three staff were enrolled for training. Sixteen (69.9%) were non-rotational. Prior to the education intervention, 18 trainees (78.3%) had placed no successful ultrasound-guided peripherally inserted venous cannulae. By 15 weeks following training, six participants (28.6%) had achieved a predetermined competency benchmark; 61.9% had placed at least one successful ultrasound-guided cannula. Difficult intravenous (IV) access predictors were present in 46.3% of patients throughout the data collection period, with infants overrepresented in this group (64.9% with difficult IV access predictors). IV access attempts by staff with prior ultrasound experience increased from 11.0 to 81.8% post-education intervention.
Conclusions:
A low-resource brief educational intervention around ultrasound-guided vascular access is achievable. Several barriers to education uptake were presented. Targeting the group of trainees with a high degree of motivation led to the highest yield of benchmark competency acquisition.
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