Abstract:
Background: Challenges with the acute central venous catheter (ACVC) insertion procedure can introduce potential delays in treatment, clinician stress, and an increase in clinical risk. A novel all-in-one insertion system may improve efficiency by decreasing procedure steps, reducing procedural challenges, and lowering the risk of some insertion-related complications.
Objectives: The primary objective of this study was to quantify the difference in total procedure time when comparing insertion of a novel all-in-one ACVC insertion system and a traditional ACVC among less experienced placers. Secondary objectives were to investigate the frequency of common procedural challenges, especially guidewire kinking, and to evaluate differences in kit and component usage.
Methods: A prospective, randomized crossover simulation study was conducted at a Medical Simulation Center. Fifty participants each placed one traditional and one novel ACVC insertion system, in randomized order, in simulated patient mannequins.
Results: The novel insertion system had a shorter total procedure time (mean difference 2.58 min, [SD ± 4.757]) when compared with a traditional ACVC (p = 0.0005). Guidewire kinking was observed across 0/49 (0%) novel insertion system placements, whereas the traditional ACVC had a significantly higher number of occurrences in 9/49 (18.4%) placements (p = 0.0039).
Conclusion: In a simulated environment, the novel insertion system reduced total procedure time and procedural challenges, particularly guidewire kinking, which may aid in prevention of guidewire complications when compared with a traditional ACVC.
Reference:Wimmer M, Donovan M, O’Brien M, Hall C, Snyder GE. Evaluating Performance With the Use of a Novel All-in-One Acute Central Venous Catheter Insertion System. J Emerg Med. 2025 Dec 13;82:64-72. doi: 10.1016/j.jemermed.2025.12.008. Epub ahead of print. PMID: 41619638.