Paramedic PapersHome Cardiac arrest Central venous access during arrest feasible in simulation
Cardiac arrest
Central venous access during arrest feasible in simulation
Feasibility of Prehospital Central Venous Cannulation During Cardiac Arrest in an Ambulance
Air Medical Journal · 2026-09-11 · Added 29 October 2026
A US simulation study in a standard ambulance found central venous cannulation technically feasible during simulated refractory shockable cardiac arrest, completed in all runs with left femoral access identified as the most practical site and ACLS interventions maintained throughout.
- Study type
- Simulation
- Design
- Simulation-based feasibility study
- Participants
- Repeated simulations with a multidisciplinary team (EMS clinicians plus a physician) in a standard ambulance
- Main finding
- Cannulation successful in all simulations via standard sterile technique; left femoral vein identified as the most practical site; main challenges were confined workspace and fixed stretcher height.
- Caveat
- Manikin simulation with a small expert team — no patient data, and real-world sterility and time costs are untested.
- Bottom line
- Hypothesis-generating
Why it matters in Australia (Medium relevance). Central venous access is beyond current Australian paramedic scope — an intensive-care-tier idea at best, and this was a manikin study with a physician on the team.
Learning goal
Weigh whether prehospital central venous access offers practical advantages over intraosseous access during refractory cardiac arrest.
More
- Topic: Cardiac arrest
- Daily scan: 29 October 2026
Related papers on Cardiac arrest
-
ECPR timing in refractory OHCA: survival gap persists
A target trial emulation in 58,668 patients with refractory OHCA from the Korean nationwide registry found ECPR was associated with higher 30-day survival at 15, 30 and 60 minutes after ED arrival (+15.0, +14.4 and +7.7 percentage points); an exploratory analysis found the benefit narrowed but remained significant to 120 minutes.
-
ECPR for OHCA: pump the brakes
A Prehospital Emergency Care commentary reviewing the ARREST, INCEPTION and Prague OHCA trials argues the ECPR evidence is not strong enough for widespread prehospital adoption, because any benefit cannot be separated from the effect of the intra-arrest transport ECPR programs require.
-
Hot nights linked to more OHCA
A nationwide time-stratified case-crossover study of 135,898 emergency hospitalisations for OHCA in Japan found hot nights (minimum temperature above the regional 92.5th percentile) were associated with a 9% higher OHCA hospitalisation risk, with the highest risks in people aged 75+ and women in northern regions.
-
Dispatcher training + volunteer app: more CPR, no outcome gain
A stepped-wedge cluster-randomised trial in French EMS agencies found dispatcher training in arrest recognition, telephone CPR and a geolocated volunteer responder app was associated with more bystander CPR (61.4% to 70.9%, adjusted OR 1.54), an effect that lost significance after adjusting for secular trends; clinical outcomes did not improve.