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. 2022 May;58(5):830-835.
doi: 10.1111/jpc.15848. Epub 2021 Dec 29.

Paediatric ultrasound-guided vascular access: Experiences and outcomes from an emergency department educational intervention

Trent Calcutt  1 , Robyn Brady  1 , Kong Liew  1
Affiliations

Paediatric ultrasound-guided vascular access: Experiences and outcomes from an emergency department educational intervention

Trent Calcutt et al. J Paediatr Child Health. 2022 May.

Abstract

Aim: This quality assurance project aims to describe the provision of an ultrasound-guided vascular access education package to paediatric emergency department staff. It subsequently aims to measure clinician and departmental responses to this educational intervention to support future effective education provision.

Methods: Participants were opt-in emergency department staff. Staff were required to be approved to insert intravenous cannulae in the department. A minimum of 50% were non-rotational staff. The educational package consisted of a theory phase (pre-learning video, information document), a practical phase (intensive 90-120 minute individualised session using a mix of live subjects/training equipment), and an embedding phase (education group available for procedural supervision). Data collection was via de-identified, encoded self-reported survey data and logbooks.

Results: Twenty-three staff were enrolled for training. Sixteen (69.9%) were non-rotational. Prior to the education intervention, 18 trainees (78.3%) had placed no successful ultrasound-guided peripherally inserted venous cannulae. By 15 weeks following training, six participants (28.6%) had achieved a predetermined competency benchmark; 61.9% had placed at least one successful ultrasound-guided cannula. Difficult intravenous (IV) access predictors were present in 46.3% of patients throughout the data collection period, with infants overrepresented in this group (64.9% with difficult IV access predictors). IV access attempts by staff with prior ultrasound experience increased from 11.0 to 81.8% post-education intervention.

Conclusions: A low-resource brief educational intervention around ultrasound-guided vascular access is achievable. Several barriers to education uptake were presented. Targeting the group of trainees with a high degree of motivation led to the highest yield of benchmark competency acquisition.

Keywords: education; emergency medicine; general paediatrics; intensive care; international child health.

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