Peripheral venous cutdown procedure: survey of residents' knowledge and practice

Abstract

Background: Peripheral venous cutdown procedure (PVCD) is a live-saving procedure that should be taught as part of core skills in undergraduate medical curricula. Every doctor should be able to perform it for administration of fluid and blood in emergency situations. However, it is doubtful that the knowledge of trainees is adequate as referral to surgical units to perform this procedure is quite high.

Objectives: This study aims at determining the most common indications and the knowledge of trainees in our centre in performing PVCD.

Methods: It is a cross-sectional questionnaire based study conducted amongst one-hundred trainees in the various clinical sub-specialties. The semi-structured selfadministered questionnaire was divided into segments on their experience, knowledge and indications for PVCD. The filled questionnaires were collected, collated and analyzed using the statistical package for the social sciences (version 16). Level of significance was determined using Chi square with p value of <0.05 considered statistically significant.

Results: There were 81 respondents consisting of 55 males and 26 females with a median age of 33 years and mean age in residency programme of 2.5 years. Sixty (74%) of the respondents have assisted in the procedure before while only seven (33.3%) have performed PVCD on their own. There was statistically difference in the performance of PVCD between surgical and non-surgical trainees (p=0.003). The commonest indication for PVCD in our centre is difficult venopuncture in patients who require fluid or blood replacements. All but one respondent agree that PVCD is a sterile procedure but only 30 (37%) trainees submitted that draping was necessary. An average of 14-15 (17.3-18.5%) residents did not answer questions on the technical details of PVCD.

Conclusion: Surgical residents have better experience and knowledge than their colleagues from other clinical departments. Efforts should be made to improve the teaching of this procedure at both undergraduate and postgraduate levels to address this knowledge gaps.

Keywords: venous cut down, trainees/residents, knowledge, practice