title: Central Venous Catheterization: Are We Using Ultrasound Guidance?
abstract: OBJECTIVE
  To assess the self-reported frequency of use of ultrasound guidance for central venous catheterization by emergency medicine (EM) residents, describe residents' perceptions regarding the use of ultrasound guidance, and identify barriers to the use of ultrasound guidance.
  
  
  METHODS
  A longitudinal cross-sectional study was conducted at 5 academic institutions. A questionnaire on the use of ultrasound guidance for central venous catheterization was initially administered to EM residents in 2007. The same questionnaire was distributed again in the 5 EM residency programs in 2013.
  
  
  RESULTS
  In 2007 and 2013, 147 and 131 residents completed questionnaires, respectively. A significant increase in the use of ultrasound guidance for central venous catheterization was reported in 2013 compared to 2007 (P< .001). In 2007, 53% (95% confidence interval, 44%-61%) of residents reported that they were initially trained in central venous catheterization using ultrasound guidance compared to 96% (95% confidence interval, 92%-99%) in 2013 (P < .0001). In 2007, more residents thought that faculty were insufficiently adopting ultrasound (42% versus 9%), and there was a lack of ultrasound teaching during residency training (14% versus 5%) compared to 2013.
  
  
  CONCLUSIONS
  The use of self-reported ultrasound guidance for central venous catheterization significantly increased from 2007 to 2013 at academic institutions. Most residents were aware of the benefits of using ultrasound guidance. Although faculty adoption of ultrasound for central venous catheterization remains a barrier, it has decreased.
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, Arizona USA (S.Ad., U.S.); Division of Emergency Medicine, Washington University, St Louis, Missouri USA (D.T.); Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York USA (C.R., M.N.); Department of Emergency Medicine, Georgia Regents University, Augusta, Georgia USA (M.L.); Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida USA (S.L.); and Department of Emergency Medicine, Albert Einstein Beth Israel Medical Center, New York, New York USA (S.Ak.). sriadhikari@aol.com.
authors.forename: Srikar
authors.initials: S
authors.lastname: Adhikari
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, Arizona USA (S.Ad., U.S.); Division of Emergency Medicine, Washington University, St Louis, Missouri USA (D.T.); Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York USA (C.R., M.N.); Department of Emergency Medicine, Georgia Regents University, Augusta, Georgia USA (M.L.); Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida USA (S.L.); and Department of Emergency Medicine, Albert Einstein Beth Israel Medical Center, New York, New York USA (S.Ak.).
authors.forename: Daniel
authors.initials: D
authors.lastname: Theodoro
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, Arizona USA (S.Ad., U.S.); Division of Emergency Medicine, Washington University, St Louis, Missouri USA (D.T.); Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York USA (C.R., M.N.); Department of Emergency Medicine, Georgia Regents University, Augusta, Georgia USA (M.L.); Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida USA (S.L.); and Department of Emergency Medicine, Albert Einstein Beth Israel Medical Center, New York, New York USA (S.Ak.).
authors.forename: Christopher
authors.initials: C
authors.lastname: Raio
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, Arizona USA (S.Ad., U.S.); Division of Emergency Medicine, Washington University, St Louis, Missouri USA (D.T.); Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York USA (C.R., M.N.); Department of Emergency Medicine, Georgia Regents University, Augusta, Georgia USA (M.L.); Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida USA (S.L.); and Department of Emergency Medicine, Albert Einstein Beth Israel Medical Center, New York, New York USA (S.Ak.).
authors.forename: Mathew
authors.initials: M
authors.lastname: Nelson
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, Arizona USA (S.Ad., U.S.); Division of Emergency Medicine, Washington University, St Louis, Missouri USA (D.T.); Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York USA (C.R., M.N.); Department of Emergency Medicine, Georgia Regents University, Augusta, Georgia USA (M.L.); Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida USA (S.L.); and Department of Emergency Medicine, Albert Einstein Beth Israel Medical Center, New York, New York USA (S.Ak.).
authors.forename: Matthew
authors.initials: M
authors.lastname: Lyon
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, Arizona USA (S.Ad., U.S.); Division of Emergency Medicine, Washington University, St Louis, Missouri USA (D.T.); Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York USA (C.R., M.N.); Department of Emergency Medicine, Georgia Regents University, Augusta, Georgia USA (M.L.); Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida USA (S.L.); and Department of Emergency Medicine, Albert Einstein Beth Israel Medical Center, New York, New York USA (S.Ak.).
authors.forename: Stephen
authors.initials: S
authors.lastname: Leech
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, Arizona USA (S.Ad., U.S.); Division of Emergency Medicine, Washington University, St Louis, Missouri USA (D.T.); Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York USA (C.R., M.N.); Department of Emergency Medicine, Georgia Regents University, Augusta, Georgia USA (M.L.); Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida USA (S.L.); and Department of Emergency Medicine, Albert Einstein Beth Israel Medical Center, New York, New York USA (S.Ak.).
authors.forename: Saadia
authors.initials: S
authors.lastname: Akhtar
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, Arizona USA (S.Ad., U.S.); Division of Emergency Medicine, Washington University, St Louis, Missouri USA (D.T.); Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York USA (C.R., M.N.); Department of Emergency Medicine, Georgia Regents University, Augusta, Georgia USA (M.L.); Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida USA (S.L.); and Department of Emergency Medicine, Albert Einstein Beth Israel Medical Center, New York, New York USA (S.Ak.).
authors.forename: Uwe
authors.initials: U
authors.lastname: Stolz
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data* / Q000639:trends; D000328:Adult; D001130:Arizona / Q000453:epidemiology; D002405:Catheterization, Central Venous / Q000706:statistics & numerical data* / Q000639:trends; D004635:Emergency Medicine / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data* / Q000639:trends; D008137:Longitudinal Studies; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D018084:Ultrasonography, Interventional / Q000706:statistics & numerical data* / Q000639:trends
keywords: catheters; central venous catheterization; emergency medicine; residents; ultrasound