title: Development and evaluation of a program for the use of ultrasound for central venous catheter placement in a pediatric emergency department.
abstract: BACKGROUND
  A growing body of literature supports the use of ultrasound (US) to assist central venous catheter (CVC) placement, and in many settings, this has become the standard of care. However, this remains a relatively new and uncommonly performed procedure for pediatric emergency medicine physicians.
  
  
  OBJECTIVE
  This study aims to describe the change over time in percentage of CVC procedures performed with US assistance per 10,000 patient visits in a pediatric emergency department.
  
  
  METHODS
  We describe the development of an emergency US program in a pediatric emergency department and investigate how US use for CVC placement in internal jugular and femoral veins changed from July 2007, when US became available, until December 2011. Data related to CVC procedures were obtained from a procedure database maintained for quality assurance purposes.
  
  
  RESULTS
  The percentage of CVC procedures performed with US assistance increased significantly over time (P < 0.001).
  
  
  CONCLUSIONS
  The development of an emergency US program was associated with significantly increased physician use of US for CVC placement.
authors.affiliation: From the Division of Emergency Medicine, Boston Children's Hospital, Boston, MA.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Vieira
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Gallagher
authors.forename: Anne M
authors.initials: AM
authors.lastname: Stack
authors.forename: Heidi C
authors.initials: HC
authors.lastname: Werner
authors.forename: Jason A
authors.initials: JA
authors.lastname: Levy
mesh_terms: D001900:Boston; D002405:Catheterization, Central Venous / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D004635:Emergency Medicine / Q000193:education*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005257:Fellowships and Scholarships; D005268:Femoral Vein / Q000000981:diagnostic imaging; D006776:Hospitals, Pediatric; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008505:Medical Staff, Hospital / Q000193:education*; D019095:Point-of-Care Systems / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D018084:Ultrasonography, Interventional / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends