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Related Experiment Videos

Pediatric venous cutdowns: utility in emergency situations.

K V Iserson, E A Criss

    Pediatric Emergency Care
    |December 1, 1986
    PubMed
    Summary

    Pediatric venous cutdowns are rarely performed by non-surgeons and take significant time, even for experts. This procedure is best reserved for experienced clinicians during emergencies when other venous access methods are failing.

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    Area of Science:

    • Pediatric Surgery
    • Vascular Access
    • Emergency Medicine

    Background:

    • Achieving timely venous access in children presents challenges.
    • Established performance standards are lacking for venous cutdowns, a last resort procedure.
    • Current methods include peripheral/central venipuncture and venous cutdowns, each with varying skill requirements.

    Purpose of the Study:

    • To assess the frequency of pediatric venous cutdowns.
    • To determine the time required for pediatric venous cutdowns across age groups.
    • To identify the common anatomical locations for pediatric venous cutdowns.

    Main Methods:

    • A survey was distributed to members of the American Pediatric Surgical Association.
    • Data collected on procedure frequency, time, and anatomical location.
    • Analysis included three pediatric age groups (neonate, 1-5 years, 6-16 years) and five physician groups.

    Main Results:

    • Pediatric surgeons perform an average of 56 cutdowns annually.
    • Procedure times ranged from 6-11 minutes for neonates and older children, respectively.
    • Venous cutdowns were infrequently utilized by pediatric residents, pediatricians, surgical residents, and general surgeons.

    Conclusions:

    • The time investment for venous cutdowns makes them impractical as a first-line emergency approach for most clinicians.
    • Pediatric venous cutdowns should be performed by experienced clinicians during emergencies, concurrent with attempts at other access methods.

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