Preparing Residents for Emergent Vascular Access: The Comparative Effectiveness of Central Venous and Intraosseous Catheter Simulation-Based Training

Abstract

Resident physicians are often required to perform central venous catheter (CVC) or intraosseous catheter (IO) placement when supervision is not readily available. We assessed whether brief CVC and IO simulationbased training increases resident knowledge and comfort performing these procedures unsupervised. Residents were assigned to either a 60-minute CVC training or a control group that received no training; they were also assigned to either a 30-minute IO training or a control group. Both trainings improved resident comfort performing the respective procedures (47% CVC intervention group vs. 26% CVC control group, p = 0.051; 47% IO intervention group vs. 16% IO control group, p = 0.006). There was also a statistically-significant summative effect of receiving both trainings, as 75% of the residents who received both trainings reported comfort obtaining unsupervised emergent vascular access. This suggests that residencies should include not only CVC, but also IO, simulation-based training sessions to prepare residents for emergency situations.