Volume 8, Issue 2, December 2020, Page: 55-61
Securing Central Venous Access and Arterial Cannulation in a COVID ICU- Our Experience Questionnaire Based Survey
Neha Rawat, Department of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Jijo Francis, Department of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Goverdhan Dutt Puri, Department of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Amarjyoti Hazarika, Department of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Naveen Naik, Department of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Kulbhusan Saini, Department of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Received: Aug. 15, 2020;       Accepted: Aug. 27, 2020;       Published: Sep. 3, 2020
DOI: 10.11648/j.ijacm.20200802.15      View  38      Downloads  28
Abstract
INTRODUCTION: PPE for contact protection is an integral component of the management of critically ill COVID-19 patients. It causes restrictions in mobility and impaired touch perception. This is further impaired by additional standard barrier precautions taken for sterility. In an era where the point of care ultrasound (POCUS) has become an everyday practice, ultrasound guidance is recommended to overcome some of these difficulties. OBJECTIVE: The objective was to find and evaluate the techniques practiced, the difficulties faced and complications while performing a central venous catheter and arterial cannula insertion. MATERIALS AND METHODS: The study was conducted through an online survey. The questionnaire included questions about the practices followed, the problems faced, and complications during performing such procedures. RESULT: 66.66% of the Senior residents and 16.6% of the Consultants attempted the CVC insertions. Arterial cannulation was attempted by 78.37% senior residents and 14.42% Consultants. Majority of intensivists used USG for CVC insertions (86.48%) and for arterial cannulation (81%). The various difficulties faced were impaired vision due to fogging (100%), impaired body movement. 66% complained of suboptimal patient positioning and 33% complained of difficulty in communication during CVC insertion. We found that there were no immediate complications. CONCLUSION: To access central and arterial cannulation in a COVID ICU, Senior intensivist should perform the procedure using USG guided techniques so as to improve success rate and minimize complication amidst difficulties like fogging of vision and improper procedural positioning. Standardized equipment for “standard” maximal barrier precautions should be available before performing these procedures in addition to PPE.
Keywords
Central Venous Catheter, Arterial Cannula, COVID-19, ICU, USG
To cite this article
Neha Rawat, Jijo Francis, Goverdhan Dutt Puri, Amarjyoti Hazarika, Naveen Naik, Kulbhusan Saini, Securing Central Venous Access and Arterial Cannulation in a COVID ICU- Our Experience Questionnaire Based Survey, International Journal of Anesthesia and Clinical Medicine. Vol. 8, No. 2, 2020, pp. 55-61. doi: 10.11648/j.ijacm.20200802.15
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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