A review of an anaesthetic led vascular access list

Summary The demand for insertion of long‐term central venous (Hickman type) catheters is thought to be increasing. Organisation is required to meet this demand in a safe and efficient manner. This report reviews the results from a dedicated, anaesthetic led vascular access list over the initial 61‐m...

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Bibliographic Details
Published in:Anaesthesia 2005-08, Vol.60 (8), p.772-778
Main Authors: Galloway, S., Sharma, A., Ward, J., Bodenham, A. R.
Format: Article
Language:English
Subjects:
Aged
Anesthesia
Anesthesia, Local
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthesiology - education
Anesthesiology - organization & administration
Biological and medical sciences
Blood vessels
Catheterization, Central Venous - methods
Catheters
Education, Medical, Graduate - methods
England
Female
Fluorescence
Humans
Male
Medical procedures
Medical sciences
Middle Aged
Preoperative Care - methods
Ultrasonic imaging
Waiting Lists
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Summary:Summary The demand for insertion of long‐term central venous (Hickman type) catheters is thought to be increasing. Organisation is required to meet this demand in a safe and efficient manner. This report reviews the results from a dedicated, anaesthetic led vascular access list over the initial 61‐month period. One thousand procedures were performed. Nine hundred and twenty catheters were inserted under local anaesthesia, with or without intravenous sedation and analgesia. Eighty catheters were removed. All procedures were performed during a dedicated once weekly, morning list. A total of 53% of all procedures were performed on a day‐case basis, 43% on in‐patients. Only 1.5% of patients required an unexpected overnight stay (usually medically unfit patients). There were 81 (9%) cancellations on the day of procedure due to neutropaenia, pneumonia or urinary tract infections. Ultrasound guidance was used initially selectively in 14%, latterly in 100% of procedures and fluoroscopy in all insertions to confirm or adjust catheter position. This service has been well received by patients and oncology services. In addition it provides an interesting area of practice for anaesthetists and an ideal environment for teaching more advanced aspects of central venous access. It may provide a template of service for other centres.
ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.2005.04189.x