Gorgone Matthew, O'Connor Timothy P, Maximous Stephanie I
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and.
University of Rochester Medical Center, Department of Emergency Medicine, Rochester, New York.
ATS Sch. 2022 Oct 26;3(4):598-609. doi: 10.34197/ats-scholar.2022-0029HT. eCollection 2022 Dec.
Ultrasound-guided peripheral intravenous (IV) placement is often required for patients with difficult IV access and is associated with a reduction in central line placement. Despite the importance, there is no standardized technical approach, and there is limited ability to attain mastery through simulation. We describe our step-by-step approach for teaching ultrasound-guided IV placement at the bedside using short-axis dynamic guidance, with emphasis on advancing the needle and catheter device almost entirely into the vessel before threading the catheter. Our teaching approach allows the opportunity for trainees to maximize the learning potential of a single insertion experience, which includes focused preprocedure hands-on practice, instruction with real-time feedback at the bedside, and a post-procedure debrief with reinforcement of concepts.
对于静脉穿刺困难的患者，常常需要超声引导下的外周静脉置管，而且这与中心静脉置管的减少有关。尽管其很重要，但目前尚无标准化的技术方法，并且通过模拟来掌握这项技术的能力有限。我们描述了一种在床旁使用短轴动态引导教授超声引导下静脉置管的分步方法，重点是在置入导管之前，将针和导管装置几乎完全推进血管内。我们的教学方法让学员有机会最大限度地发挥单次置管操作的学习潜力，其中包括术前有针对性的实践操作、床旁实时反馈指导以及术后强化概念的总结汇报。
