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Vascular Access Support Team: A Multi-Disciplinary Response to Optimise Patients’ Care during COVID-19 Pandemic
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  • Manish Sinha,
  • Prakash Saha,
  • Nabil Melhem,
  • Nicos Kessaris,
  • Lukla Biasi,
  • Caroline Booth,
  • Chris Callaghan,
  • Tommaso Donati,
  • Marlies Ostermann,
  • Sanjay Patel,
  • Nick Ware,
  • Hany Zayed,
  • Martin Drage,
  • Morad Sallam
Manish Sinha
Evelina London Children's Hospital

Corresponding Author:[email protected]

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Prakash Saha
Guy's and St Thomas' NHS Foundation Trust
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Nabil Melhem
Evelina London Children's Hospital
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Nicos Kessaris
Guy's and St Thomas' NHS Foundation Trust
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Lukla Biasi
Guy's and St Thomas' NHS Foundation Trust
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Caroline Booth
Evelina London Children's Hospital
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Chris Callaghan
Guy's and St Thomas' NHS Foundation Trust
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Tommaso Donati
Guy's and St.Thomas' NHS Foundation Trust
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Marlies Ostermann
Guy's and St Thomas' Hospitals NHS Trust
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Sanjay Patel
Guy's and St Thomas' NHS Foundation Trust
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Nick Ware
Evelina London Children's Hospital
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Hany Zayed
Guy's and St Thomas' NHS Foundation Trust
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Martin Drage
Guy's and St.Thomas' NHS Foundation Trust
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Morad Sallam
Guy's and St Thomas' NHS Foundation Trust
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Abstract

Objectives: To evaluate clinical outcomes of multidisciplinary vascular access support team (VAST) and the value of the service to critical care teams. Design: Prospectively collected data. Material and methods: All patients requiring vascular access at St Thomas’ Hospital, London over a 5-week period during the first wave of the pandemic in the UK. At the end of study period, online anonymised questionnaire administered to critical care team members, including nursing and medical professionals, to evaluate their experience of the service. Results: 122 patients aged 52.1 ± 13 years with high rate of pre-existing co-morbidities, underwent line insertion including 190 catheters (central venous n=182, arterial n=8). Median (range) number of 5 (0-17) lines were placed per day in patients of whom 90% tested positive for Severe Acute Respiratory Syndrome Coronavirus-type 2 pathogen (SARS-CoV-2). A single line was inserted in 146 out of 172 patients (76.8%) and n=36 patients (18.9%) ‘double puncture’ technique used. 45 line insertions (24%) had complications with minor [bleeding (n=19), line infection (n=10)] and 2 lines (1%) with major complication. The survey respondents, n=54 professionals, highlighted ease of referral and timely access placement (>90% responses); with agreement that VAST service saved them precious time and allow them to focus on other jobs. Conclusions: We describe the successful deployment of a multidisciplinary vascular access team with low complication rates and high rates of satisfaction. We recommend similar models can be considered by health services to optimise patient care and ICU management.
Oct 2021Published in Journal of Critical Care volume 65 on pages 184-185. 10.1016/j.jcrc.2021.06.011