In the position statement released by the Society of Hospital Medicine (SHM), Franco–Sadud et al. outline the transformative effects ultrasound can have in obtaining adult vascular access” Anstey and Lai (2019).
Is there a single intervention more important to hospitalized patients than vascular access? Since their advent in the 1950s, small plastic tubes have revolutionized medication administration and become a mainstay of modern medicine. Yet, for much of the last 60 years, nurses and doctors have used the same landmark-guided approaches to acquire peripheral and, more specifically, central access.1 Minor improvements to the Seldinger technique and sterile preparation have been reported.2 However, for such a vital and common procedure, the complication rates of landmark-based approaches to central venous access remain unacceptably high.3
In the position statement released by the Society of Hospital Medicine (SHM), Franco–Sadud et al. outline the transformative effects ultrasound can have in obtaining adult vascular access.4 The authors cite comprehensive evidence, leaving little doubt of the technique’s benefits compared with landmark-based approaches. However, several questions remain: Is vascular access the domain of the hospitalist? If so, how can hospitalists pursue and afford ultrasound training? Finally, how will this shift toward ultrasound-guided vascular access affect patients in resource-limited settings?
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Anstey, J.E. and Lai, A.R. (2019) Expanding the View: Implications of the SHM Position Statement on Ultrasound Use in Vascular Access. Journal of Hospital Medicine. September 6th. doi: 10.12788/jhm.3299. .