Purpose: The use of ultrasound for central venous catheter (CVC) insertion and regional anesthesia (RA) has been recommended to improve efficacy and patient safety. We conducted a survey to evaluate the degree to which ultrasound use has been adopted into routine practice by anesthesiologists in the province of Ontario, Canada.
Methods: Following approval by the Research Ethics Board at The Hospital for Sick Children, we conducted a web-based survey of anesthesiologists registered with the College of Physicians and Surgeons of Ontario. The anesthesiologists surveyed were working in academic or community hospitals. The survey elicited information on the degree of routine use of ultrasound for CVC or RA blocks, reasons for non-use of ultrasound, and methods of ultrasound training.
Results: A questionnaire was sent to 450 anesthesiologists via e-mail. There were 209 (46%) respondents, six of whom were excluded as the anesthesiologists were no longer in practice, resulting in 203 responses for analysis. Of these, 163 anesthesiologists practiced in academic hospitals, and 40 practiced in community hospitals. A larger proportion of academic (60%) vs community (33%) anesthesiologists use ultrasound routinely for CVC insertion (P = 0.004). Routine use for RA blocks was comparable in both groups. The most common reason given for non-use of ultrasound for CVC insertion was "ultrasound is unnecessary for safe/effective insertion of CVCs". Peer-to-peer training was the most preferred method for improving ultrasound skills.
Conclusions: The use of ultrasound is better established in academic than in community anesthesia practice. Anesthesiologists in community practice appear to be adopting ultrasound at a slower pace, which may be explained by lack of equipment and lack of training.