Ultrasound guidance for central vascular access in the pediatric emergency department.
Central vascular access is sometimes required for hemodynamic monitoring and infusion of fluids and medications in the pediatric emergency department. In many cases, it is attempted after failed peripheral venous and intraosseous access. Some evidence exists demonstrating benefits of ultrasound (US)-guided central vascular cannulation in adults in emergency departments. With appropriate education in its use, US-guided cannulation of central veins in children is likely to be associated with less complications and greater success. In the pediatric emergency department, the femoral vein is the most practical central venous cannulation site. A sound educational and quality assurance program is necessary for US-guided cannulation in the pediatric emergency department.
Skippen
Peter
P
Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Kissoon
Niranjan
N
D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003199:Computer Systems; D003362:Cost-Benefit Analysis; D004630:Emergencies; D004635:Emergency Medicine / Q000193:education / Q000379:methods*; D004636:Emergency Service, Hospital; D005268:Femoral Vein / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007601:Jugular Veins / Q000000981:diagnostic imaging; D015201:Meta-Analysis as Topic; D010372:Pediatrics / Q000193:education / Q000379:methods*; D011785:Quality Assurance, Health Care; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D013350:Subclavian Vein / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler / Q000191:economics / Q000295:instrumentation