The use of ultrasound as an adjunct to peripheral venous cannulation by junior doctors in clinical practice

Abstract

Purpose: There is little consensus on the role of training in bedside ultrasound skills for medical students or junior doctors early in their careers.Methods: We trained 20 Foundation Year 1 doctors in the use of ultrasound as an adjunct to peripheral venous cannulation and following an assessment of competence gave them access to an ultrasound machine to assist with difficult cannulations in their clinical practice. Self-reported confidence and competence were assessed using pre- and post-training questionnaires, with competence objectively assessed immediately post-training and at one and three months follow up. Clinical use of ultrasound was studied over three months.Results: Improvements in self-reported confidence and competence were observed post-training and retained at three months. 85% (17/20) of participants were objectively assessed as competent immediately post-training, with retention of competence demonstrated in 80% (16/20) and 75% (15/20) at one and three months, respectively. There were 33 separate uses of ultrasound during the three month study period with a 73% (24/33) success rate and no adverse incidents.Conclusions: We suggest that doctors in their first post-graduate year can be trained in the use of ultrasound as an adjunct to peripheral venous cannulation, retain the skill over time and use it safely in their clinical practice.