How to Prevent and Manage Malpositioned Central Lines

Right SCV-IJ case
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Central line, Events, Featured, Infections, Medical General, medical procedures
More Tags – central line, central line complications, Central line insertion, central line malpositioning, featured, femoral lines, HPC updates, IJ lines, Simulation Based Training; Central Line Training, subclavian lines
Malpositioned central venous catheters occurs in about 7% of central line placements. A malpositioned central line is any central venous catheter where the tip is located anywhere other than the superior vena cava (SVC) for internal jugular lines or subclavian…
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First Pass Success Rate is Better for Ultrasound-Guided Radial Artery Line Placement vs Palpation-Guided Placement

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Arterial line, Central line, Featured, medical procedures
More Tags – Arterial line insertion, Arterial lines, HPC updates, ultrasound-guided arterial lines
In 2015 a meta-analysis found that when an ultrasound was used during a radial arterial catheter placement the first pass success rate improved. In the eleven trials that met inclusion criteria over 800 patients were enrolled. Compared to the palpation-guided…
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Procedural Competency in Academic Emergency Medicine Attending Physicians

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Emergency Procedures, Endotracheal Intubation, Featured, Intraosseous line, Lumbar Puncture, medical procedures, Paracentesis, Pericardiocentesis, Procedural Sedation, Respiratory diseases, Thoracentesis
More Tags – ACLS, chest tube placement, difficult airway management, endotracheal intubation, featured, HPC updates, intraosseous line placement, intubation, lumbar puncture, paracentesis, pericardiocentesis, procedural sedation, thoracentesis, tube thoracostomy
A recent article summarizes a cross-sectional survey aimed at determining the processes in place to assess the procedural competency of academic emergency medicine attendings.[i] The survey was sent to the 39 ACGME-accredited Emergency Medicine programs in the U.S. and had…
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Simulation Based Training Improves Airway Management Skills

https://hospitalprocedures.org/endotracheal-intubation-course/
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Endotracheal Intubation, Featured Procedure, Gastrointestinal diseases, Glidescope Intubation, King Tube, Laryngeal Mask Airway, Lumbar Puncture, Mechanical Ventilation, Medical General, medical procedures, Paracentesis, Respiratory diseases, Thoracentesis
More Tags – airway management, central lines, endotracheal intubation, Glidescope intubation, King tube, laryngeal mask airway, lumbar puncture, paracentesis, thoracentesis
Simulation-based procedural training has been shown to improve procedural competence, safety, operator confidence and most importantly patient safety for every bedside procedure studied.  Now, a new systematic review and meta-analysis confirms that simulation-based training in airway management improves procedural competence…
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