Evaluation of training in pediatric ultrasound-guided vascular cannulation using a model

• Main Authors: José Manuel Lopez-Alvarez, Olivia Pérez-Quevedo, Joaquín Naya-Esteban, Teresa Ramirez-Lorenzo, Sira Alonso-Graña López-Manteola, Dionisio Lorenzo Lorenzo-Villegas
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Journal of Medical Ultrasound
• Subjects: pediatrics; simulation; ultrasound; vascular access
• Online Access: http://www.jmuonline.org/article.asp?issn=0929-6441;year=2021;volume=29;issue=3;spage=171;epage=175;aulast=Lopez-Alvarez
• ISSN: 0929-6441; 2212-1552

Background: The study objective was to evaluate a training program and a training model for pediatric ultrasound-guided vascular cannulation (USGVC) by inexperienced operators. Methods: An observational descriptive study was conducted at the pediatric intensive care unit of a level-III hospital. The study protocol comprised the following parts: (1) pretraining test; (2) theory and practice training session consisting of an explanation of basic vascular ultrasound concepts plus performing vascular cannulation in a model; (3) posttraining test; and (4) evaluation of the training model. Results: A total of 25 health-care professionals participated in the study. All of them possessed the skills to locate vessels and ultrasound planes, and they performed USGVC using the training model. On a 1–5 scale, the model was rated to have 87.6% fidelity with real pediatric patients; the best regarded aspect of it was utility (93%). Differences were found between pre- and post-training scores: 2.72 ± 0.84 versus 4.60 ± 0.50; P < 0.001 (95% confidence interval: −2.28, −1.47). Altogether, 300 ultrasound-guided cannulation procedures were carried out (12 per participant) distributed along the longitudinal axis in plane and the transverse axis out of plane, with 150 punctures in each of them. The success rate for USGVC in the training model was 79.7%, the mean time for the procedure was 115.6 ± 114.9 s, and the mean time for achieving successful cannulation was 87.69 ± 82.81 s. The mean number of trials needed for successful USGVC was 1.49 ± 0.86. Conclusion: After undergoing the theory–practice training, participants: (a) improved their knowledge of ultrasound-guided vascular access; (b) positively evaluated the USGVC training model, in particular its utility and fidelity as compared with cannulation in pediatric patients; and (c) achieved a high USGVC success rate in a relatively short time.