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Paeds Casesinvestigations-procedures-and-technology

Paeds Cases · investigations-procedures-and-technology

Central venous and arterial access in children — OSCE

OSCE procedural-planning station for a child requiring central venous access, with a structured oral of site selection, ultrasound-guided Seldinger technique, and complication management.

osce procedural-planning station2 min readVerification in progress

Target exams

MRCPCH ClinicalRACP DCE
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Study tools

Target exams

MRCPCH ClinicalRACP DCE
Prompt
You have 9 minutes with a 3-year-old in septic shock who needs central access for an adrenaline infusion and is thrombocytopenic. Choose and justify the site, talk through the ultrasound-guided Seldinger technique, confirm the tip, and describe how you would manage an arterial puncture during the attempt.

Station brief (candidate)

  • Choose and justify the central venous site for this thrombocytopenic child in septic shock, and state which site you would avoid and why.
  • Talk through the ultrasound-guided Seldinger technique at your chosen site, naming each step.
  • Describe how you would confirm correct catheter tip position, and how you would manage an arterial puncture during the attempt.
  • Outline your central line-associated bloodstream infection prevention bundle. [1] [8]
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References5ShowHide
  1. [1]Lamperti M International evidence-based recommendations on ultrasound-guided vascular access. Intensive Care Med, 2012.PMID 22614241
  2. [3]Brass P Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization. Cochrane Database Syst Rev, 2015.PMID 25575245
  3. [8]Duesing LA Central Venous Access in the Pediatric Population With Emphasis on Complications and Prevention Strategies. Nutr Clin Pract, 2016.PMID 27032770
  4. [11]Zito Marinosci G ECHOTIP-Ped: A structured protocol for ultrasound-based tip navigation and tip location during placement of central venous access devices in pediatric patients. J Vasc Access, 2023.PMID 34256613
  5. [12]Buetti N Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update. Infect Control Hosp Epidemiol, 2022.PMID 35437133
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