Advertisement

Ultrasound-Guided Peripheral Venous Access

  • Lori StolzEmail author
Chapter

Abstract

Difficult peripheral venous access is commonplace in healthcare. It is disruptive to patient care, and failure to obtain venous access impedes delivery of care in a timely manner. Failure to obtain peripheral access may lead to central line placement and subsequent increased risk to the patient secondary to the many complications of central lines. Ultrasound-guided peripheral access allows clinicians to obtain peripheral access in situations where blind-, landmark-, or palpation-based techniques fail. The proper technique for ultrasound-guided peripheral venous access requires a different skill set than that of traditional intravenous catheter placement and is best performed in the long axis. It can be used to access the antecubital veins, the forearm veins, the saphenous vein or the deep veins of the upper extremity, the basilic vein, and the brachial veins. Utilizing ultrasound guidance for the placement of peripheral venous catheters leads to increased success, fewer needle sticks, fewer complications, and increased patient satisfaction compared to landmark- or palpation-based techniques in patients with difficult venous access.

Keywords

Peripheral access Intravenous access Peripheral catheter IV Peripherally inserted central venous catheter Ultrasound guidance 

References

  1. 1.
    Centers for Disease Control. National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department summary tables. 2010. http://www.cdc.gov.ezproxy2.library.arizona.edu/nchs/data/ahcd/nhamcs_emergency/2010_ed_web_tables.pdf. Accessed 27th Jan 2015.
  2. 2.
    Witting MD. IV access difficulty: incidence and delays in an urban emergency department. J Emerg Med. 2012;42(4):483–7.  https://doi.org/10.1016/j.jemermed.2011.07.030.CrossRefPubMedGoogle Scholar
  3. 3.
    Sebbane M, Claret PG, Lefebvre S, Mercier G, Rubenovitch J, Jreige R, et al. Predicting peripheral venous access difficulty in the emergency department using body mass index and a clinical evaluation of venous accessibility. J Emerg Med. 2013;44(2):299–305.  https://doi.org/10.1016/j.jemermed.2012.07.051.CrossRefPubMedGoogle Scholar
  4. 4.
    Miles G, Salcedo A, Spear D. Implementation of a successful registered nurse peripheral ultrasound-guided intravenous catheter program in an emergency department. J Emerg Nurs: JEN. 2012;38(4):353–6.  https://doi.org/10.1016/j.jen.2011.02.011.CrossRefPubMedGoogle Scholar
  5. 5.
    Cummings EA, Reid GJ, Finley GA, McGrath PJ, Ritchie JA. Prevalence and source of pain in pediatric inpatients. Pain. 1996;68(1):25–31.CrossRefGoogle Scholar
  6. 6.
    Fields JM, Piela NE, Ku BS. Association between multiple IV attempts and perceived pain levels in the emergency department. J Vasc Access. 2014;15(6):514–8.  https://doi.org/10.5301/jva.5000282.CrossRefPubMedGoogle Scholar
  7. 7.
  8. 8.
    Liang SY, Marschall J. Update on emerging infections: news from the Centers for Disease Control and Prevention. Vital signs: central line-associated blood stream infections--United States, 2001, 2008, and 2009. Ann Emerg Med. 2011;58(5):447–51.  https://doi.org/10.1016/j.annemergmed.2011.07.035.CrossRefPubMedGoogle Scholar
  9. 9.
    O‘Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):e162–93.  https://doi.org/10.1093/cid/cir257.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Schoenfeld E, Shokoohi H, Boniface K. Ultrasound-guided peripheral intravenous access in the emergency department: patient-centered survey. West J Emerg Med. 2011;12(4):475–7.  https://doi.org/10.5811/westjem.2011.3.1920.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Adhikari S, Blaivas M, Morrison D, Lander L. Comparison of infection rates among ultrasound-guided versus traditionally placed peripheral intravenous lines. J Ultrasound Med. 2010;29(5):741–7.CrossRefGoogle Scholar
  12. 12.
    Egan G, Healy D, O’Neill H, Clarke-Moloney M, Grace PA, Walsh SR. Ultrasound guidance for difficult peripheral venous access: systematic review and meta-analysis. Emerg Med J. 2013;30(7):521–6.  https://doi.org/10.1136/emermed-2012-201652.CrossRefPubMedGoogle Scholar
  13. 13.
    Heinrichs J, Fritze Z, Vandermeer B, Klassen T, Curtis S. Ultrasonographically guided peripheral intravenous cannulation of children and adults: a systematic review and meta-analysis. Ann Emerg Med. 2013;61(4):444–54 e1.  https://doi.org/10.1016/j.annemergmed.2012.11.014.CrossRefPubMedGoogle Scholar
  14. 14.
    Stolz LA, Stolz U, Howe C, Farrell IJ, Adhikari S. Ultrasound-guided peripheral venous access: a meta-analysis and systematic review. J Vasc Access. 2015;0(0):0.  https://doi.org/10.5301/jva.5000346.CrossRefGoogle Scholar
  15. 15.
    Shokoohi H, Boniface K, McCarthy M, Khedir Al-tiae T, Sattarian M, Ding R, et al. Ultrasound-guided peripheral intravenous access program is associated with a marked reduction in central venous catheter use in noncritically ill emergency department patients. Ann Emerg Med. 2013;61(2):198–203.  https://doi.org/10.1016/j.annemergmed.2012.09.016.CrossRefPubMedGoogle Scholar
  16. 16.
    Au AK, Rotte MJ, Grzybowski RJ, Ku BS, Fields JM. Decrease in central venous catheter placement due to use of ultrasound guidance for peripheral intravenous catheters. Am J Emerg Med. 2012;30(9):1950–4.  https://doi.org/10.1016/j.ajem.2012.04.016.CrossRefPubMedGoogle Scholar
  17. 17.
    Netter FH. Atlas of human anatomy. 5th ed. Philadelphia: Saunders/Elsevier; 2011.Google Scholar
  18. 18.
    Elia F, Ferrari G, Molino P, Converso M, De Filippi G, Milan A, et al. Standard-length catheters vs long catheters in ultrasound-guided peripheral vein cannulation. Am J Emerg Med. 2012;30(5):712–6.  https://doi.org/10.1016/j.ajem.2011.04.019.CrossRefPubMedGoogle Scholar
  19. 19.
    Witting MD, Schenkel SM, Lawner BJ, Euerle BD. Effects of vein width and depth on ultrasound-guided peripheral intravenous success rates. J Emerg Med. 2010;39(1):70–5.  https://doi.org/10.1016/j.jemermed.2009.01.003.CrossRefPubMedGoogle Scholar
  20. 20.
    Panebianco NL, Fredette JM, Szyld D, Sagalyn EB, Pines JM, Dean AJ. What you see (sonographically) is what you get: vein and patient characteristics associated with successful ultrasound-guided peripheral intravenous placement in patients with difficult access. Acad Emerg Med. 2009;16(12):1298–303.  https://doi.org/10.1111/j.1553-2712.2009.00520.x.CrossRefPubMedGoogle Scholar
  21. 21.
    Stone MB, Moon C, Sutijono D, Blaivas M. Needle tip visualization during ultrasound-guided vascular access: short-axis vs long-axis approach. Am J Emerg Med. 2010;28(3):343–7.  https://doi.org/10.1016/j.ajem.2008.11.022.CrossRefPubMedGoogle Scholar
  22. 22.
    Schofer JM, Nomura JT, Bauman MJ, Hyde R, Schmier C. The “Ski Lift’’: a technique to maximize needle visualization with the long-axis approach for ultrasound-guided vascular access. Acad Emerg Med. 2010;17(7):e83–e84.  https://doi.org/10.1111/j.1553-2712.2010.00784.x.CrossRefGoogle Scholar
  23. 23.
    Brannam L, Blaivas M, Lyon M, Flake M. Emergency nurses’ utilization of ultrasound guidance for placement of peripheral intravenous lines in difficult-access patients. Acad Emerg Med. 2004;11(12):1361–3.  https://doi.org/10.1197/j.aem.2004.08.027.CrossRefPubMedGoogle Scholar
  24. 24.
    Walker E. Piloting a nurse-led ultrasound cannulation scheme. Br J Nurs (Mark Allen Publishing). 2009;18(14):854, 6, 8–9.CrossRefGoogle Scholar
  25. 25.
    Weiner SG, Sarff AR, Esener DE, Shroff SD, Budhram GR, Switkowski KM, et al. Single-operator ultrasound-guided intravenous line placement by emergency nurses reduces the need for physician intervention in patients with difficult-to-establish intravenous access. J Emerg Med. 2013;44(3):653–60.  https://doi.org/10.1016/j.jemermed.2012.08.021.CrossRefPubMedGoogle Scholar
  26. 26.
    Bauman M, Braude D, Crandall C. Ultrasound-guidance vs. standard technique in difficult vascular access patients by ED technicians. Am J Emerg Med. 2009;27(2):135–40.  https://doi.org/10.1016/j.ajem.2008.02.005.CrossRefPubMedGoogle Scholar
  27. 27.
    Schoenfeld E, Boniface K, Shokoohi H. ED technicians can successfully place ultrasound-guided intravenous catheters in patients with poor vascular access. Am J Emerg Med. 2011;29(5):496–501.  https://doi.org/10.1016/j.ajem.2009.11.021.CrossRefPubMedGoogle Scholar
  28. 28.
    Aponte H, Acosta S, Rigamonti D, Sylvia B, Austin P, Samolitis T. The use of ultrasound for placement of intravenous catheters. AANA J. 2007;75(3):212–6.PubMedGoogle Scholar
  29. 29.
    Benkhadra M, Collignon M, Fournel I, Oeuvrard C, Rollin P, Perrin M, et al. Ultrasound guidance allows faster peripheral IV cannulation in children under 3 years of age with difficult venous access: a prospective randomized study. Paediatr Anaesth. 2012;22(5):449–54.  https://doi.org/10.1111/j.1460-9592.2012.03830.x.CrossRefPubMedGoogle Scholar
  30. 30.
    Costantino TG, Kirtz JF, Satz WA. Ultrasound-guided peripheral venous access vs. the external jugular vein as the initial approach to the patient with difficult vascular access. J Emerg Med. 2010;39(4):462–7.  https://doi.org/10.1016/j.jemermed.2009.02.004.CrossRefPubMedGoogle Scholar
  31. 31.
    Costantino TG, Parikh AK, Satz WA, Fojtik JP. Ultrasonography-guided peripheral intravenous access versus traditional approaches in patients with difficult intravenous access. Ann Emerg Med. 2005;46(5):456–61.CrossRefGoogle Scholar
  32. 32.
    Doniger SJ, Ishimine P, Fox JC, Kanegaye JT. Randomized controlled trial of ultrasound-guided peripheral intravenous catheter placement versus traditional techniques in difficult-access pediatric patients. Pediatr Emerg Care. 2009;25(3):154–9.  https://doi.org/10.1097/PEC.0b013e31819a8946.CrossRefPubMedGoogle Scholar
  33. 33.
    Kerforne T, Petitpas F, Frasca D, Goudet V, Robert R, Mimoz O. Ultrasound-guided peripheral venous access in severely ill patients with suspected difficult vascular puncture. Chest. 2012;141(1):279–80.  https://doi.org/10.1378/chest.11-2054.CrossRefPubMedGoogle Scholar
  34. 34.
    Stein J, George B, River G, Hebig A, McDermott D. Ultrasonographically guided peripheral intravenous cannulation in emergency department patients with difficult intravenous access: a randomized trial. Ann Emerg Med. 2009;54(1):33–40.  https://doi.org/10.1016/j.annemergmed.2008.07.048.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.University of Cincinnati, Department of Emergency MedicineCincinnatiUSA

Personalised recommendations