Training and supervision of temporary transvenous pacemaker insertion

To assess the current training and practice of central venous cannulation and temporary transvenous pacemaker insertion, a telephone survey of senior house officers (n = 60) and registrars (n = 20) was carried out in 80 acute hospitals in England and Wales. A median of one central line and two pacings were performed under supervision before the respondents were left unsupervised. The procedures were almost invariably taught at the bedside and usually by a fellow SHO or registrar. Virtually all the doctors surveyed were familiar with subclavian puncture, but experience with other routes was limited; 39/80 doctors questioned were unhappy about the training they had received, and 47 felt that formal training, such as tutorials or videos, would have helped. Training in central vein cannulation and temporary pacing needs to be more structured. This could be done by the use of videos or mannequins, and should include the use of routes other than the subclavian.