In other ED ultrasound applications, it is acceptable to learn on humans, either volunteers or patients. However, in vascular access, the invasive nature requires a certain amount of training on simulators.
The most basic simulator is a thin tube in a block of soft gel, and these can be made readily.
This type of simulator helps the trainee to gain the hand-eye co-ordination required, together with the angle of approach.
Several central venous simulators exist, and these aim to provide a life-like image of the anatomy, while allowing a simulation vessel to be cannulated. Internal jugular cannulation should be learned in this way if possible. The trainee who already has experience in central venous cannulation will be able to migrate to ultrasound-guided cannulation without a great deal of training, compared to the trainee who has never carried out the technique.
In all instances there is the need for sufficient one-to-one supervision by the trainer.