RESUMO
QUALITY PROBLEM OR ISSUE: Ultrasound (US) is a widely propagated medical technology. Anaesthesiologists increase procedural safety by using US techniques, but training and availability are essential for its usage. Although its utility for central venous catheterisation (CVC) is well established, only a paucity of evidence is available regarding its use in low- and middle-income countries. This study is a nationwide survey of Colombian anaesthesiologists designed to explore the current use of US guidance for CVC. INITIAL ASSESSMENT AND IMPLEMENTATION: Web-based survey at National level. Anaesthesiologists registered in the Colombian Society of Anaesthesiology and Resuscitation database. CHOICE OF SOLUTION: Demographic variables (age and gender), anaesthesia expertise, years of anaesthesiology practice, US availability, use of US during CVC, reasons for not using US and training experience were collected. EVALUATION: Of 351 respondents (12.3% response rate), 45% reported using US sometimes and always for CVC (95% CI 39%-50%) (n = 157). Most anaesthesiologists obtained training in US through external courses (50.4%) or from colleagues (22.8%). Of the total respondents, 62.7% (n = 220) have US equipment available at all time and this factor was independently associated with the use of US for CVC (adjusted odds ratio [OR] = 38.6, P < 0.001). LESSONS LEARNED: US guidance is not a common technique used for CVC by Colombian anaesthesiologists; an important barrier for its use is lack of equipment.
Assuntos
Anestesiologistas/educação , Cateterismo Venoso Central/métodos , Ultrassonografia de Intervenção/instrumentação , Ultrassonografia de Intervenção/métodos , Adulto , Competência Clínica , Colômbia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Sonography has gained a broad field of applications in current anesthetic practice. During airway management, it could have an important role, because it allows real-time measurement of anatomical aspects and a functional evaluation with high safety profile. However, assessment of the reliability and precision of these measurements is critical if sonography is used as a clinical diagnostic tool. The aim of the study was to estimate inter-rater and intra-rater reliability of the airway diameter measured by sonography in heathy volunteers. METHODS: We conducted a cross-sectional study during 2015 on healthy adult volunteers. Using sonography, transverse internal diameter of subglottic space was measured twice by two blinded sonographers. RESULTS: Agreement was classified as very good for intra-rater measurements (ICC = 0.84) and good for the inter-rater measurements (ICC = 0.71). The 95% CI of agreement limits for the intra-rater measurements were inferior to those for the inter-rater measurements. CONCLUSIONS: Ultrasound measurement is a reliable and precise method to measure the internal subglottic diameter of the airway. Ultimately, this method may provide clinicians valuable information regarding airway diameter in adults and may help to guide treatment options.