An easily assembled phantom for teaching ultrasound-guided vascular access.

To the Editor, Ultrasound-guided catheterization is an essential skill for central venous catheterization and difficult peripheral vascular access. Compared with landmark techniques, it is associated with higher rates of successful cannulation and fewer complications. Safe, effective use of ultrasound, however, requires operator skill. Trainees must develop the dexterity needed to manipulate the probe while safely guiding the needle to the desired target. This skill includes being able to maintain visualization of the needle tip at all times in both longand short-axis views. We share here a simple, practical phantom for teaching trainees ultrasoundguided vascular access. Various phantoms for ultrasound-guided procedures have been described, including commercially available manikins (e.g., Blue Phantom; CAE Healthcare, FL, USA) and homemade models crafted with gelatin, agar, or silicone tubing and a variety of meats such as pork and chicken breasts. Unfortunately, food-based phantoms are impractical for the operating room (OR), and commercial products are expensive. Other homemade phantoms require time to prepare and are therefore unsuitable for impromptu teaching in the OR. We describe here a simple ultrasound phantom that can be quickly assembled with basic supplies found in any OR: a 250-mL saline bag (Baxter International, Mississauga, ON, Canada), a 26Fr Foley catheter (Bard Medical, Covington, GA, USA), a 22G Quinke spinal needle (Becton-Dickinson, Mississauga, ON, Canada), a Savaday cardboard tray (CKF Inc., Langley, BC, Canada) or similar basin. The saline bag is placed on top of the Foley catheter with a Savaday tray underneath to catch any spilled fluid. The Foley catheter may be filled with any solution (e.g., methylene blue) using a cathetertipped syringe and clamped at the distal end. Trainees are instructed to practice advancing the needle through the saline bag toward the Foley tubing or balloon while trying to maintain visualization of the needle tip with the ultrasound probe in both shortor long-axis views. The Foley catheter can be indented to simulate a real-life vessel wall prior to penetration (Figure). Once the Foley is