Using Simulation Models to Train Clinicians in the Use of Point-of-Care Ultrasound

Summary

The present protocol describes an ideal solution to train novices in the use of point-of-care ultrasound devices for the practical clinical skill of visually assessing distinct individual anatomical vascular conditions prior to and during an intended venous vascular cannulation using point-of-care ultrasound in a patient.

Abstract

The use of point-of-care ultrasound (POCUS) has shown to be a beneficial non-invasive vascular access assessment method by clinicians, which can provide critical elements of visual and measurable information that proves to be useful in the context of vascular access cannulation, in combination with the practical skill of the clinician performing the cannulation. However, the use of POCUS in this context is to practically train and enable individuals who are novices in using this technique to become proficient in performing this task subsequently on patients in a careful and successful way. The simulation of these vascular conditions may be useful to help healthcare professionals learn, understand, apply, and establish such practical skills for vascular cannulation safely to achieve the desired outcomes. This project intended, through the attendance of a half-day workshop, to establish skills to use POCUS in connection with simulation models and perform specific tasks to enable clinicians to use this method in their clinical practice for vascular access cannulation in patients. A mixed-methods longitudinal study design was used to evaluate the effect of a point-of-care ultrasound workshop for peripheral intravenous cannula insertion, including specific tasks for the participants to be performed on simulation models. A total of 81 individuals participated in 11 half-day workshops through 2021 and 2022. Offering a workshop that uses simulation models in combination with various POCUS devices is useful in establishing this newly learned skill in clinicians, such as measurements of depth, caliper, and direction of a vein with POCUS prior to cannulation providing essential anatomical facts to the operator, which increases the likelihood of first-time success in cannulation.

Introduction

Most patients being admitted to acute hospitals receive at least one peripheral intravenous catheter (PIVC), with the purpose of withdrawing blood, administration of fluids and/or medication, and for diagnostic purposes¹. It is common that first-attempt insertions fail, and it has been reported that up to 50% of hospitalized patients have difficult intravenous access (DIVA)². To alleviate this, the use of ultrasound-guided PIVC insertion (USGPIVC) has been demonstrated to improve insertion success rates, and training and practical education have been recommended for multiple healthcare professions³

Protocol

This study was approved by the Human Research Ethics Committee of Edith Cowan University, Reference Number REMS 2021-02489-STEINWANDEL. Informed consent was obtained from workshop participants, and a copy of a participant information sheet was provided. Only workshop participants who participated in one of the ultrasound workshops during the delivery period between the years 2021 and 2022 were invited to participate and included in this study. All subsequent workshop participants in 2023 and 2024 were excluded from parti.......

Discussion

Vascular access cannulation of difficult venous conditions requires experience, manual dexterity, and continuous observation of the progress of the needle tip position while the cannula is advanced through human tissue into the intravascular space¹⁸. While the use of ultrasound has become more prevalent in the use in patients with difficult venous access², it is also necessary that junior clinicians and novices become familiar with the use of ultrasound in connection with i.......

Materials

Name	Company	Catalog Number	Comments
BD Insyte Autogard BC Pro shielded IV catheter with blood control technology (PIVC)	BD	318054
Catheter tipped syringe 30 or 50 ml	BD Plastipak	301229, 300865
Celeste Nitrile Powder Free Examination gloves sizes S/M/L (non-sterile)	Celeste	CLS121
Goliath Cling wrap	Goliath
modelling balloons 260 Q	Qualatex	99321
Point-of care ultrasound device, eg. Philips Lumify or Vscan Air	Philips or GE Healthcare		https://www.usa.philips.com/healthcare/product/HC989605450382/lumify-c5-2-curved-array-transducer
probe cover for Philips lumify	Philips		https://www.usa.philips.com/healthcare/product/HC989605450382/lumify-c5-2-curved-array-transducer
raw chicken breast
Sunsonic Ultrasound Transmission Gel 250 ml	Sunsonic	LG250
Tasty Herbal Infusion Rosehip Tea	Tasty
Victorinox Fibrox Chef's Knife 20 cm	Victorinox	40520