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Related Experiment Video

Updated: Jun 20, 2026

The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire

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Published on: December 23, 2014

Ultrasound-Based SECURED Protocol for Central Venous Catheterization: A Feasibility Study.

Moon Soo Choi¹, Han Ho Do¹, Jeong Hun Lee¹

¹Department of Emergency Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea, dongguk.edu.

Biomed Research International

|June 19, 2026

Summary

The SECURED protocol standardizes ultrasound use for central venous catheterization, improving safety and reducing complication detection time. This six-step POCUS workflow ensures efficient and effective patient care in critical settings.

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Area of Science:

Emergency Medicine
Critical Care
Point-of-Care Ultrasound (POCUS)

Background:

Central venous catheterization (CVC) is vital for critically ill patients but carries risks of mechanical complications.
Current ultrasound-guided (USG) CVC practices are often fragmented, limiting their full potential.
The SECURED protocol was developed to integrate POCUS into a standardized, six-step CVC workflow.

Purpose of the Study:

To evaluate the feasibility and effectiveness of the SECURED protocol for central venous catheterization.
To assess the protocol's completion rate and its impact on complication detection.
To compare the time efficiency of ultrasound-based complication detection with traditional chest radiography.

Main Methods:

A prospective observational study involving 109 adult patients undergoing internal jugular vein (IJV) CVC in the emergency department (ED).
The SECURED protocol includes pre- and post-procedure ultrasound scans of the IJV, pleura, and heart.
Primary endpoint: protocol completion rate. Secondary endpoint: time for complication detection via ultrasound vs. chest radiography.

Main Results:

The SECURED protocol demonstrated a 100% completion rate in all 109 cases.
The protocol identified pre-existing IJV thrombosis, prevented arterial punctures, and detected venous dissection.
Ultrasound-based detection of pneumothorax and catheter malposition was significantly faster (2.5 min) than chest radiography (12.4 min).

Conclusions:

The SECURED protocol offers a practical, time-efficient screening framework for CVC.
It standardizes POCUS use, enabling proactive risk detection and immediate post-procedural confirmation.
Further validation in larger studies may support broader implementation for improved clinical decision-making.