Premium
Use of sterile saline as a conduction agent for ultrasound visualization of central venous structures
Author(s) -
Windish Ryan,
Ungar Todd,
Backlund Brandon,
Haukoos Jason S,
Kendall John
Publication year - 2010
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/j.1742-6723.2010.01297.x
Subject(s) - medicine , saline , visualization , ultrasound , anesthesia , radiology , data mining , computer science
Abstract Objective: To determine whether sterile saline as a conduction agent provides adequate visualization of anatomic structures to attempt ultrasound‐guided vascular access. Methods: This prospective study involved a convenience sample of adult patients (18 years and older) who presented to an urban academic ED during a 3‐month study period. Each patient had three six‐second ultrasound video clips obtained of the right internal jugular vein and surrounding structures utilizing three different conduction agents, water‐based gel (the control), sterile saline or no conduction agent. Video clips were randomized and assigned a numeric code to blind reviewers to the conduction agent. They were then independently reviewed by two experts who determined whether anatomic structures were visualized with enough detail to perform ultrasound‐guided vascular access. The reviewers also rated the overall image quality of each video clip using a 100 mm visual analogue scale (VAS). Results: Forty‐seven patients were included in the final analysis. The raw agreement was 100% (95% confidence intervals [CI]: 93–100%) with a kappa of 1.0 between the two reviewers in assessing whether they would be able to perform vascular access using the images obtained using saline as a conduction agent. The median VAS for gel across both reviewers was 92 (95% CI: 90–93) and the median VAS differences for saline and no medium were –3 (95% CI: –1 to –3) and –46 (95% CI: –22 to –61), respectively. Conclusions: The use of sterile saline as a conduction agent allows adequate visualization of anatomic structures to attempt ultrasound‐guided vascular access.