title: Should ultrasound guidance be used for central venous catheterisation in the emergency department?
abstract: In September 2002, the National Institute of Clinical Excellence (NICE) issued guidelines for England and Wales suggesting that ultrasound guidance should be used for all electives, and should be considered for most emergency, central venous catheterisations.1 These guidelines propose a major change of practice for most clinicians practising in UK Emergency Departments. There are also resource and training implications. In this paper we systematically review the literature to establish what evidence exists for the routine use of ultrasound guidance in the placement of central venous catheters in adult patients attending the Emergency Department, and provide an overview of the practical elements of this procedure.
authors.affiliation: Emergency Department, Box 87, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK. drpaulatkinson@ntlworld.com
authors.forename: P
authors.initials: P
authors.lastname: Atkinson
authors.forename: A
authors.initials: A
authors.lastname: Boyle
authors.forename: S
authors.initials: S
authors.lastname: Robinson
authors.forename: G
authors.initials: G
authors.lastname: Campbell-Hewson
mesh_terms: D000328:Adult; D002405:Catheterization, Central Venous / Q000379:methods*; D003422:Critical Care / Q000379:methods; D004636:Emergency Service, Hospital / Q000592:standards*; D019317:Evidence-Based Medicine; D006077:Government Agencies; D006801:Humans; D015201:Meta-Analysis as Topic; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D014463:Ultrasonography / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods* / Q000592:standards; D006113:United Kingdom
references.citation: Anesthesiology. 1984 May;60(5):481-2
references.pmid: 6711857
references.citation: Arch Intern Med. 1986 Feb;146(2):259-61
references.pmid: 3947185
references.citation: Anesthesiology. 1986 Jun;64(6):830-1
references.pmid: 3717653
references.citation: Chest. 1990 Jul;98(1):157-60
references.pmid: 2193776
references.citation: Anesth Analg. 1991 Jun;72(6):823-6
references.pmid: 2035868
references.citation: Circulation. 1993 May;87(5):1557-62
references.pmid: 8491011
references.citation: N Engl J Med. 1994 Dec 29;331(26):1735-8
references.pmid: 7984193
references.citation: Crit Care Med. 1995 Apr;23(4):692-7
references.pmid: 7661944
references.citation: Crit Care Med. 1996 Dec;24(12):2053-8
references.pmid: 8968276
references.citation: Am J Emerg Med. 1997 Jan;15(1):79-82
references.pmid: 9002578
references.citation: Ann Emerg Med. 1997 Mar;29(3):331-6; discussion 337
references.pmid: 9055771
references.citation: AJR Am J Roentgenol. 1997 Sep;169(3):731-3
references.pmid: 9275887
references.citation: Intensive Care Med. 1997 Aug;23(8):916-9
references.pmid: 9310813
references.citation: Am J Emerg Med. 1998 Jul;16(4):401-3
references.pmid: 9672463
references.citation: Acad Emerg Med. 2002 Aug;9(8):800-5
references.pmid: 12153885
references.citation: J Crit Care. 2002 Jun;17(2):126-37
references.pmid: 12096376
references.citation: J Accid Emerg Med. 2000 May;17(3):170-5
references.pmid: 10819377
references.citation: BMJ. 2003 Aug 16;327(7411):361
references.pmid: 12919984