Vascular Access Support Team: A Multi-Disciplinary Response to Optimise
Patients’ Care during COVID-19 Pandemic
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.