Document Detail


A dedicated consultant-led vascular access team significantly reduces out-of-hours and emergency permanent central venous access insertions.
MedLine Citation:
PMID:  20152365     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The insertion of a permanent central venous access device (PCVAD i.e. Broviac or Hickman lines and vascuports) is often considered a low priority and performed as an emergency. In 2004, a vascular access team (VAT), responsible for all PCVAD insertions, was established in our institution to address this. METHODS: Data were collected retrospectively on all PCVAD insertions in 2 periods (January 2002-December 2003 and January 2005-December 2006). This included procedure, list type, surgeon grade, and operative time. RESULTS: During 2002 to 2003 and 2005 to 2006, 465 and 569 PCVADs were inserted, respectively (22% increase). After introduction of the VAT, the percentage of lines inserted during emergency lists fell from 24% (n = 112) to 13% (n = 72), and out-of-hours fell from 6% (n = 29) to 3% (n = 17; P < .05), respectively. Median time taken for PCVAD insertion in 2005 to 2006 was significantly less if using an elective list compared with insertions performed on an emergency list (elective, 67 [56-82] minutes vs emergency, 85 (65-110) minutes; P < .05). DISCUSSION: Introduction of a VAT has led to a significant decrease in emergency and out-of-hours PCVAD insertions, despite an increase in overall activity for the period. The median time taken for elective insertions is significantly less than emergency insertions, which has increased the efficiency of vascular access provision at our institution.
Authors:
John M Wells; Wajid B Jawaid; Peter Bromley; James Bennett; G Surren Arul
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  45     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-15     Completed Date:  2010-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  419-21     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Pediatric Surgery, Birmingham Children's Hospital, Steelhouse Lane, B4 6NH Birmingham, UK.
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MeSH Terms
Descriptor/Qualifier:
After-Hours Care / statistics & numerical data
Catheterization, Central Venous / methods*,  statistics & numerical data,  trends
Catheters, Indwelling / statistics & numerical data*
Consultants / statistics & numerical data*
Emergency Medical Services / methods*,  statistics & numerical data
Emergency Service, Hospital / standards
Hospitals, Pediatric / statistics & numerical data
Humans
Patient Care Team / standards
Retrospective Studies
Surgical Procedures, Elective / statistics & numerical data
Time Factors
Time and Motion Studies*

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


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