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Gina Ward
ER docs utiliziing ultrasound for central lines


Once again this question comes up in our recent preparation for the "aim for zero" campaign.  


Are your ED physicians utilizing ultrasound?    There is a statement in the HCA aim for zero under the section of "education and competency" 

      Technology to improve insertion ( ie ultrasound guidance) is evaluated and utililized when appropriate.


Our risk manager seems to think we have a "gap" or need for iimprovement since the ER docs never need to borrow my ultrasound.

Ihave 2 critical care pulmonologists  who ocassionally place central lines or Swanz Ganz  catheters and only one borrows my US, and he typically uses it to visualize the juglars and then doesnt actually use it for his insertion.  

How are your docs doing ?  Do you consider it a deficiency if they dont utilize ultrasound? 

Thanks in advance !  Gina Ward


Dr. Jack LeDonne, surgeon

Dr. Jack LeDonne, surgeon from Baltimore definitely thinks that placing any CVC without US is below the standard of care. He presents on this issue frequently at AVA and was doing this topic at WoCoVA last week. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Use of US

Jack is a very persuaive speaker.

I have one surgeon who uses my US to mark out the vein but not during the procedure and one anesthsiologist who is very interested that I have helped use it a couple of times for IJ......and that's all. The surgeon is young and just recently trained. I think you will find more and more phsicians using US as time goes by because many are being trained now in residency programs.

We have some older docs who are so good at placing central lines that as an RN I would feel like an idiot telling them that they really should be using US.

Our ED docs do not use US and they should. We get way too many femoral lines out of the ED. When I ask them about it they tell me they are interested but of course, they don't ever seem to have the time.

Richard Simpson RN, CCRN

The only physicians in our

The only physicians in our hospital that use ultrasound is our Interventional Radiologists.  Thankfully, our ECC docs do not place very many and if they do a femoral insertion we remove and place an alternate within 24 hours.  We cannot even "go there" with our anesthesiologists.  So we do have a gap but the number of insertions besides ourselves and IR is very small (like 2/month).  We are a 300 bed hospital.

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