Document Detail


Real-time ultrasound-guided femoral vein catheterization during cardiopulmonary resuscitation.
MedLine Citation:
PMID:  9055771     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To compare the use of real-time-ultrasound guidance with the standard landmark-oriented approach for obtaining femoral vein catheterization in patients requiring intravenous access during CPR. METHODS: Prospective, randomized, paired subject-controlled clinical trial in the setting of an urban teaching county hospital emergency department. The study comprised a convenience sample of 20 patients presenting with apnea and pulselessness in the ED. Each patient received bilateral femoral lines, one by ultrasound guidance and one by the landmark approach (control). Randomization determined which technique and which side would be attempted first. The following parameters were recorded: time to initial flash of blood, time to completion of catheterization, number of needle passes, and rate of arterial catheterization. CPR and Advanced Cardiac Life Support protocols were continued during both procedures. RESULTS: Real-time ultrasound-guided catheterization had a higher success rate (90% versus 65%, P = .058), a lower number of needle passes (2.3 +/- 3 versus 5.0 +/- 5, P = .0057), and a lower rate of arterial catheterization (0% versus 20%, P = .025) than the standard landmark-oriented approach. Ultrasound was also slightly faster in time to blood flash and in time to catheterization. An incidental finding of interest was that real-time ultrasound demonstrated the presence of femoral vein pulsations during CPR. CONCLUSION: Real-time ultrasound-guided femoral vein catheterization was faster and produced a lower rate of inadvertent arterial catheterization and a higher rate of success during CPR than the standard landmark-oriented approach. Also, ultrasound demonstrated that palpable femoral pulsation during CPR is venous rather than arterial.
Authors:
W M Hilty; P A Hudson; M A Levitt; J B Hall
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  29     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-03-28     Completed Date:  1997-03-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  331-6; discussion 337     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, Highland General Hospital, Oakland, California, USA. hilty@itsa.ucsfi.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Catheterization, Peripheral / methods*
Female
Femoral Artery / ultrasonography*
Femoral Vein / physiology,  ultrasonography*
Heart Arrest / therapy*
Humans
Male
Middle Aged
Prospective Studies
Pulse
Resuscitation*
Sensitivity and Specificity
Comments/Corrections
Comment In:
ACP J Club. 1997 Jul-Aug;127(1):15

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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