EM Quickloop Survey

Survey

  • Online, anonymous 10 question survey.
  • Distributed to list-serve members for Emergency Medicine and Pediatric Emergency Medicine Providers.
  • About 1,000 members and roughly 30% response rate.

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Take Away Points

  • Survey completed by a diverse national group of Pediatric and General Emergency Medicine practitioners.
  • Of the respondents, 62% are familiar with the loop technique, 29% have tried it, 15% have seen it done.
  • Of the respondents who use the technique (n=88), 40% use it in over half of all of their drainage procedures.
  • Of the respondents who use the technique (n=88), loop is the preferred method for draining large abscesses (69%).
  • 4% of respondents do not believe that the technique works as well as standard incision & drainage.
  • Most common reasons for NOT using the loop technique aside from unfamiliarity is:
    • Lack of appropriate equipment.
    • Technique "takes too long".
    • Concerns about follow-up and colleague buy-in.

Q1: What is your primary practice setting?

  • Total Answers: 327
  • Chose more than 1 answer: 22

Q2: Please describe your practice.

  • Total Answers: 304/305
  • Total Answers: 167/305

​Q3: If you finished training within last 5 years, please identify the region where you trained, otherwise identify the region where you currently practice.

  • Total Answers: 249/305

Q4: Are you familiar with vessel loop technique for cutaneous abscess drainage?

  • Total Answers: 304/305

Q5: Have you ever drained an abscess using the vessel loop technique?

  • Total Answers: 303/305

Q6: What is your preferred way to drain simple/small (<2 cm) cutaneous abscesses?

  • Total Answers: 303/305

Q7: What is your preferred way to drain complex/large (>2 cm) cutaneous abscesses?

  • ​Total Answers: 303/305

Q8. What percentage of your drainage procedures are done with loop drainage technique?

  • Total answers: 300/305
  • Total answers loop > 50%: 37/300 (12.3%) 

​Q9. What percentage of your drainage procedures are done with use of moderate sedation?

  • Total Answers: 300/305
  • Total Answers Sedation > 50% =  69/303 (34.5%)

Q10.  What are the barriers to using the Vessel Loop Technique in your practice?

  • Total Answers: 297/305
  • 43% say they don't use it because they don't feel comfortable/have never learned how

Verbatim Provider Comments for Question 10 of the Survey

  • In my pediatric patients, standard I&D works well even in larger abscesses. If I have an unusual or at all concerning abscess, I don't drain it, I call a peds surgeon.
  • PAs do the majority of these procedures.                
  • I use a cut up tourniquet which is OK but less than optimal                
  • I have not seen evidence that has convinced me to change practice            
  • Occasionally they go out of stock, and we have to call in the OR supplies.        
  • Not our standard practice in our standard work guidelines (clinical path)
  • I use it but would prefer a different vessel loop- right now I use a Penrose drain
  • No MD championing it - we just haven't really tried it much                
  • Note Jacobi ring uses standard butterfly tubing                
  • Need appropriate follow up, buy-in by surgical colleagues and acceptance by PMDs
  • I believe simple I&D works well, so have not tried to learn this technique
  • When we can FIND a vessel loop (finding one is my only barrier- not always available) to use, I always prefer it, especially in perianal/gluteal/perineal abscesses
  • No idea what it is, but I'm going to find out!
  • I have seen several patients 2-3 days after vessel loop was placed with worsening abscess/had to take it out and perform standard I&D- unsure if not placed correctly or due to abscess type/complexity
  • With small children, it may be difficult for the parent to move the loop daily to keep open due to age of child, pain degree, comfort level of parent. Also, I find we don't have a ton of abscesses that require full I and D
  • the product is not available at my facility
  • patients have to be complaint with moving the loop (and most won't) and it doesn't always seem to adequately drain all of the pus. a lot of time we don't have the loop in the ED for easy access and it's faster for me to do a regular i&d
  • I don't use it because I would like to see the rates of complications in comparison to the original packing vs loop
  • I have seen instances where it does not work as well as an I&d
  • may be appropriate for large, small may need no additional packing/ follow-up
  • Not convinced it is a superior technique
  • One hospital I work at doesn't have vessel loops. I try to keep some in my bag but that is a limiting factor
  • It take me longer to do loop technique and tends to require more sedation than standard
  • Most docs that micromanage would probably have me undo it. And that could change shift to shift. that happens when Texas doesn't let you own your own work
  • I don't believe it to be superior, and believe it takes longer to do than a standard I&D
  • I works fine but increase procedure time is not offset by increased effectiveness
  • I never think of it. Previous used the old JP or tube drainage. Pts complained of the messy drainage ports
  • It is also not standard practice where I work and could create some confusion for follow-up physicians.
  • In my practice I feel that adequate anesthesia allowing sufficient probing and breaking of loculations is most important
  • General surgeons don't believe in vessel loops
  • I have to send to the OR ever time I want to use a loop, and that slows me down.

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The Quickloop Device

​We designed the Quickloop to simplify the "loop" technique for various abscess applications.  In addition, it offers several features that will improve outcomes, save provider time and decrease overall cost of caring for patients with abscesses.