Do not undertake any practical procedure unless you are competent to do so. Please ensure that the first time you undertake a procedure at JCUH is supervised by a Consultant or senior staff grade.
The clean utility areas in each unit contain ready prepared trays containing all the required equipment for a particular procedure (arterial line, central line, tracheostomy). There are also trays set for chest drain and lumbar puncture. After you have completed the procedure ensure all sharps and clinical waste are disposed of. Return the used tray to the dirty utility and ask a healthcare assistant to restock. Nursing staff request that arterial lines are sutured in place.
The use of ultrasound to assist central line placement is mandatory. We have 3 machines for line placement and a Logibook e-ultrasound scanner for echo / chest ultrasound used by Consultants or with supervision (not for use for routine line placement by junior staff). Please ask to be shown how to use the machines. There will be a teaching session in the first few weeks to help you.
There are teaching videos and papers from the New England Journal of Medicine (see below) to provide you with a practical guide and background information about commonly performed procedures. There are also pathways for most of the procedures combined with a LocSSIP (Local Safety Standards for Invasive Procedures), which are mandated to use every time you perform a procedure. You should be supervised by a senior trainee at all times whilst learning.
Information and LoCSSIPs for some of the procedures
Arterial Line Insertion Video
Central Venous Catheter Insertion
Femoral Vein Catheter Insertion
USS Insertion of Peripheral Vein Access
Chest Drain Insertion
Needle Aspiration of Pneumothorax
Care of Vascular Access Devices