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BACKGROUND	Placing a central venous access device via the internal jugular or subclavian vein entails significant risks to both patient and healthcare worker .
OBJECTIVE	The purpose of this randomized , prospective study was to determine whether the accelerated Seldinger technique ( AST ) offers significant safety advantages over the modified Seldinger technique ( MST ) for peripherally inserted central catheter insertion .
METHODS	Patients were randomly assigned to undergo introducer sheath insertion by means of either MST or AST .
METHODS	Primary outcome measures included time to completion of introducer sheath insertion , estimated blood loss , and success rate .
METHODS	Secondary outcome measures included vessel-to-air exposure events and unprotected sharps exposure .
CONCLUSIONS	While both insertion methods proved equivalent for successful vessel cannulation , AST was significantly faster ( P = 0.0048 ) and resulted in less blood loss ( P = 0.0295 ) than MST .
CONCLUSIONS	Additionally , AST resulted in significantly fewer vessel-to-air exposure events ( P < 0.0001 ) and unprotected sharps exposures ( P < 0.0001 ) .
CONCLUSIONS	Although this was a relatively small and unblinded study , the high degree of statistical significance of the study results suggests that , for both patients and healthcare workers , AST is faster and safer than MST for PICC peelable introducer sheath insertion .

