Should the landmark technique for vascular access continue to be taught – Full Text

"In our experience, it takes a lot of practice to acquire the necessary cognitive and psychomotor skills to perform ultrasound-guided procedures. It is therefore necessary to take every opportunity to practice in order to be ready for the complicated cases" Borgquist and Kander (2025).

"In our experience, it takes a lot of practice to acquire the necessary cognitive and psychomotor skills to perform ultrasound-guided procedures. It is therefore necessary to take every opportunity to practice in order to be ready for the complicated cases" Borgquist and Kander (2025).

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Should the landmark technique for vascular access continue to be taught

Extract:

“We agree that ultrasound guidance will not completely avoid complications. Like any technique, it must be used correctly. However, we feel that the occasional “misuse” of a superior method does not justify teaching a clearly inferior one. If anything, it underscores the need to devote more teaching time to ultrasound, not less. In our experience, it takes a lot of practice to acquire the necessary cognitive and psychomotor skills to perform ultrasound-guided procedures. It is therefore necessary to take every opportunity to practice in order to be ready for the complicated cases. Why waste time practicing an outdated technique? Which patient would want to be the target of landmark practice?

We agree with the authors that ultrasound is no longer a luxury—it is available in almost all practice settings. Instead of hedging our bets with fallback techniques from a previous era, we should be maximizing training time on the reliable, safe, and standard technique that real-time ultrasound guidance represents. It’s time to leave the landmark era behind.”

Reference:

Borgquist O, Kander T. The Landmark Technique for Vascular Access: R.I.P. J Cardiothorac Vasc Anesth. 2025 Jul 10:S1053-0770(25)00563-4. doi: 10.1053/j.jvca.2025.07.005. Epub ahead of print. PMID: 40738816.