Conventional vs Ultrasound Guided Arteria Cannulation.
Condition: Disorder of Cardiac Function
Study type: Interventional

Summary: 
      The aim of the project is to compare two methods for arterial cannulation. The traditional
      method with ultrasound guided cannulation. The investigators goal is to improve this
      procedure to reduce pain and complications.
    

Detailed description: 
      The practice of placing vascular catheters is used many times every day at almost every
      hospital. It is a safe procedure which generally does not imply problems. Though the
      procedural optimum aren't reached. The procedure still fails some times and induce
      complications. When the catheter is placed using the traditional method the pulse is palpated
      by the operator's fingers. This is only to be done near the hand wrist. In this position the
      catheter steadiness is fragile but because the pulse can't be sensed more proximal the
      operator is forced to choose this position. This it though a problem that can be solved by
      non invasive visualization technology. Ultrasound-guidance for central vascular access is
      already well-established. However, in recent years ultrasound-guidance for peripheral
      vascular access has gained popularity too. The evidence of multiple studies demonstrates
      increased success rate and reduced complication rate with ultrasound compared to blind
      landmark technique for vascular catheter placement.

      In recent years there have been both procedural technique and technology improvements in the
      field of ultrasound. This has led to the improvement of procedural catheterisation techniques
      that now can be done by novices with higher attempt success rate than traditional method. One
      technique that is gaining success is the short-axis-out-of-plane technique (SAX-OOP) with
      dynamic-needle-tip-tracking (DNTT).Using the ultrasound machine the needle can be placed in a
      more proximal direction on the forearm and the investigators believe that by the help of the
      exposed procedure on the monitor many complications can be reduced.

      It has been shown that inexperienced trainees lear the technique SAX-OOP and DNTT very
      quickly.

      First investigators hypothesize that the number of attempts, the number of withdrawals, the
      time spend and the number of utilized catheters will be decreased using ultrasound vs. the
      traditional method. Secondly investigators hypothesize that the pain induced by the
      conventional method inclusive preoperational lidocaine injection will be the same or more
      intense than using DNTT with local anesthesia. Thirdly investigators claim that the best
      anatomical place to put the catheter isn't always corresponding with the spot chosen by
      palpation, which increase the number of failures. Fourthly investigators hypothesize that the
      use of ultrasound will increase the operator's subjective feeling of having accomplished a
      successful procedure.
    

Intervention name(s): Traditional palpation technique; Ultrasound DNTP
Intervention type(s): Procedure; Procedure
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Participant)