For a study, researchers sought to determine if ultrasound-guided subclavian vein catheterization was safer and more effective than the standard landmark approach in the emergency department.

From April 2004 to June 2009, a prospective randomized experiment was undertaken in an urban tertiary care academic emergency department (ED) with an annual census of more than 50,000 patients. The following key data endpoints were calculated: overall success for resident and attending doctors; the number of tries by each provider group; complication rate with each approach; and time to get the subclavian line.

A total of 85 participants were included in the trial. When compared to the landmark approach, the ultrasound method was more successful in attaining subclavian catheter placement. When successful cannulation attempts in both groups were evaluated, the ultrasound group had a statistically significantly longer time to success than the landmark group. There was no difference in complication or success rates between residents and attending doctors. In addition, there was no statistically significant difference in the incidence of complications between ultrasound-guided and landmark techniques.

In an emergency department scenario, ultrasound-guided subclavian vein catheterization was linked with a greater overall success rate than the landmark approach, with no significant difference in complication rate.

Reference: jem-journal.com/article/S0736-4679(21)00909-4/fulltext