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• W2068871982 abstract "The Central Line Emergency Access Registry (CLEAR) creates a multi-center web-based registry study to analyze the experience of emergency medicine (EM) physicians with the placement of central venous catheters (CVC). Our primary objective is to assess operator success rates by post-graduate year (PGY) and prior experience with central venous catheter insertion. The multi-center data collection of CLEAR began in November 2006, and currently 9 emergency medicine residency programs are participating. Patients greater than 18 years of age requiring a CVC placement by an EM physician are included. Variables recorded include: indication, number of attempts, placement site, complications, patient and physician demographics, ultrasound use and sterile technique. Data is analyzed using Excel® and STATA® software. EM physicians needed 785 attempts to successfully insert catheters in 634 patients as of April 15, 2007 at the nine participating centers. Overall physician success rate was 80% and catheters were placed successfully in 97% of patients. CVC insertion is most common in the ED (69%) and ICU (30%). Common indications for CVC insertion are poor peripheral IV access (27%), need for frequent lab draws/multiple medications (25%) and need for rapid resuscitation (18%). Sterile technique was used for 84% of central line placements. Comparison of practitioners who inserted 10-30 central lines vs. those with < 10 central lines showed an odds ratio of success 2.2 (95% CI 1.82-2.67). No significant difference was noted when comparing the other groups (10-30, 31-50, and >50). PGY did not correlate with success rate (PGY-1 vs.2: OR 1.67, 95% CI 1.05-2.22. PGY-2 vs. 3:OR 1.65, 95% CI 0.98-1.98). Physicians who placed more than ten CVC have a higher chance of success than those with less experience, but the success rate reaches a plateau after ten CVC. Surprisingly, we did not find a correlation with PGY success rates. Future directions will focus on complication rates by PGY level, success rates by anatomic location and PGY level, and prevalence of ultrasound use at each anatomic site." @default.
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• W2068871982 date "2007-10-01" @default.
• W2068871982 modified "2023-09-27" @default.
• W2068871982 title "Clear Central Line Emergency Access Registry: A Multi-Center Study to Determine Resident Competency in Placement of Central Venous Catheters" @default.
• W2068871982 doi "https://doi.org/10.1016/j.jemermed.2007.08.017" @default.
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