Anatomical Landmark vs. Ultrasound Identification of the Femoral Vein

IF 1.6 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-12-01 Epub Date: 2025-08-16 DOI:10.1016/j.jemermed.2025.08.002

Theresa Sonka MD, Haley Musgrave MD , Joshua L. Choe MD, Lauren Diercks MD, Meredith Kim MD, Trent C. Schneider MD, Steven Field DO, Gregory Cervenka MD, Joya Singh DO, Bhaskar Thakur PhD, Lynn Roppolo MD

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引用次数: 0

Abstract

Background

Fast, accurate femoral vein identification is important for providing life-saving therapies via central venous access in the emergency department.

Objective

We aim to determine the accuracy of the anatomical landmark technique for finding the femoral vein vs. the ultrasound-guided technique. We hypothesize that the femoral vein location using anatomical landmarks is, on average, 10 mm or more away from the femoral vein location found using ultrasound.

Methods

A convenience sample was recruited from a large county emergency department and the femoral vein location was determined through both methods, with the location determined by ultrasound being considered the true location of the vein. The mean distance between the ultrasound-guided femoral vein location and the anatomical landmark estimates (defined as “delta”) was measured. Data were transformed on a natural log scale and p-value for mean delta > hypothesized mean was reported. For exploratory subgroup analysis, p-value for a nonzero difference between subgroup delta means was reported.

Results

A total of 87 patients consented to participate. The average delta was 14.29 mm, which was significantly higher than the hypothesized mean (p = 0.0038). Subgroup analysis suggested that the average delta in the body mass index (BMI) < 25 group was significantly lower than the average delta in the BMI ≥ 25 group (11.77 mm vs. 16.23 mm; p = 0.0157). Measurements made by researchers with hand length of < 205 mm were significantly different from those made by researchers with hand length of ≥ 205 mm (17.42 mm vs. 11.74 mm; p = 0.0020). However, the average delta between the anatomical landmark estimate and ultrasound-guided location in the BMI < 25 group and researcher hand length ≥ 205 mm group still exceeded 10 mm.

Conclusion

Therefore, the anatomical landmark technique is not accurate in identification of the femoral vein within 10 mm of the true location determined by ultrasound.

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解剖标志与超声鉴别股静脉

背景快速、准确的股静脉识别对于在急诊科通过中心静脉通道提供挽救生命的治疗非常重要。目的比较解剖标记技术与超声引导技术寻找股静脉的准确性。我们假设使用解剖标志的股静脉位置平均距离超声发现的股静脉位置10毫米或更多。方法从某大型县级急诊科抽取方便样本，采用两种方法确定股静脉位置，以超声确定的位置为静脉的真实位置。测量超声引导下的股静脉位置与解剖标记估计（定义为“delta”）之间的平均距离。数据在自然对数尺度上进行转换，并报告了均值δ的p值>；假设均值。对于探索性亚组分析，报告了亚组δ均值之间非零差异的p值。结果共有87例患者同意参与。平均δ值为14.29 mm，显著高于假设平均值（p = 0.0038）。亚组分析显示，BMI≥25组的平均delta显著低于BMI≥25组（11.77 mm vs. 16.23 mm, p = 0.0157）。手长为205 mm的研究人员测量值与手长≥205 mm的研究人员测量值存在显著差异（17.42 mm vs. 11.74 mm, p = 0.0020）。然而，在BMI <； 25组和研究者手长≥205 mm组中，解剖标记估计值与超声引导位置之间的平均delta值仍然大于10 mm。结论解剖标记技术在超声确定的真实位置10 mm范围内识别股静脉是不准确的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine