Magnetic needle-tracking device for ultrasound guidance of radial artery puncture: A randomized study on a simulation model.

INTRODUCTION: Ultrasound-guidance of radial artery catheter insertion improves the first attempt success and reduces the occurrence of hematomas. Needle-tracking devices optimize needle-ultrasound beam alignment by displaying in real-time the needle tip position. We compared the median time need by experienced physicians to achieve radial artery puncture using either a conventional ultrasonography device (CUD) or a magnetic needle-tracking ultrasound device (MUD) in a simulation training arm model. METHODS: Fifty experienced residents and physicians performed two punctures in randomized order with the CUD and the MUD. The primary outcome was puncture duration; the secondary outcomes were puncture success, rate of accidental vein puncture, and practitioner's comfort (subjective scale 0-10). RESULTS: The median [lower-upper quartile] puncture time was 10 [6-14] seconds when using CUD and 4 [3-7] seconds when using MUD (P < .01). In the multivariate analysis, MUD use was associated with decreased puncture duration whatever the puncture order (OR 1.13 [1.07-1.20], P < .01). The participants performed 99 (99%) successful punctures: 50 with the MUD (100%) and 49 with the CUD (98%). There was no accidental venous puncture. The practitioner's comfort level was 6.5 [6, 7] with the CUD and 8 [7-9] with the MUD (P < .01). CONCLUSION: MUD reduced radial artery puncture time and improved physician comfort in a simulation training arm model.

Pocket-sized ultrasound device for internal jugular puncture: A randomized study of performance on a simulation model.

INTRODUCTION: The aims of our study were to compare the performance of experienced emergency physicians for internal jugular vein puncture using a conventional ultrasound device versus a pocket-sized ultrasound in a training model. METHODS: In this single-center, prospective, randomized study, emergency physicians performed one puncture with each device in a randomized order. No emergency physicians used a pocket-sized ultrasound for central vascular catheter insertion in clinical practice. A medium-fidelity training model was used. Each image was judged based on an image quality scale from 0 to 5. RESULTS: Twenty emergency physicians were included: nine females (45%), median experience 2.5 years [2.0;4.3]. The median time to achieve a puncture with the conventional ultrasound device was 22 s [17;26] versus 28 s [13;43] with the pocket-sized ultrasound (p = 0.43). Eighteen (90%) emergency physician punctures were successful with the conventional ultrasound device versus 18 (90%) with the pocket-sized ultrasound (p = 1). The image quality was 4 [3;5] in the conventional ultrasound device group versus 4 [3;5] in the pocket-sized ultrasound group (p = 0.32). CONCLUSION: Pocket-sized ultrasound and conventional ultrasound device performances are not statistically different for internal jugular vein-guided ultrasonography in a training model. These results must be confirmed in a clinical study.