Ultrasound guidance during central venous catheterization: a survey of use by house staff physicians.
OBJECTIVE
The objective of this study is to explore the attitudes, knowledge, and behavior of house staff physicians regarding the use of ultrasound guidance (UG) during central venous catheter placement (CP).


METHODS
A questionnaire-based study was used to survey house staff in multiple training programs at an academic tertiary care center.


RESULTS
Fifteen percent of the respondents reported using UG on at least 60% of CP attempts. Those house staff physicians who agreed that UG is faster, easier, and more convenient than the landmark method reported more frequent use. Agreement that UG reduces the number of mechanical complications and placement failures was also associated with increased use. Respondents reporting the most CP experience were least likely to use UG. Most agreed that UG is useful in patients without good landmarks or when the landmark method failed, but these attitudes were not associated with the frequency of UG use. Most respondents were not aware of controlled trials demonstrating the benefits of UG.


CONCLUSIONS
The use of UG during CP is infrequent despite the demonstrated benefits of this technology. Multiple knowledge and attitudinal barriers to the greater use of UG during CP must be addressed in the design of an effective UG implementation strategy.
Girard
Timothy D
TD
Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-8300, USA. timothy.girard@vanderbilt.edu
Schectman
Joel M
JM
D001291:Attitude of Health Personnel; D002405:Catheterization, Central Venous / Q000379:methods*; D003625:Data Collection; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008511:Medicine; D013038:Specialization; D014463:Ultrasonography; D014680:Veins / Q000000981:diagnostic imaging*