Ultrasound-Guided Intravenous Access

Excerpt

Approximately 300 million peripheral intravenous catheters (PIVCs) are placed annually in the U.S., nearly double the number reported in studies from previous decades. Up to 80% of adult and 70% of pediatric hospitalized patients require the placement of a PIVC. Factors complicating insertion include obesity, dehydration, end-stage renal disease, peripheral vascular disease, diabetes, intravenous drug use, sickle cell disease, and prior chemotherapy. Patients with limb amputations, arteriovenous fistulas, and vascular access devices such as dialysis catheters, peripherally inserted central catheters (PICCs), and implanted ports face limited options for PIVC placement. Difficult and prolonged attempts increase patient discomfort and frustrate the proceduralist.

Ultrasound-guided intravenous (USGIV) access techniques facilitate PIVC placement in these patients. USGIV placement suits patients across all age groups. Studies demonstrate first-attempt success rates up to 90% for USGIV insertion performed by trained providers, exceeding rates achieved with standard methods. Successful USGIV placement reduces emergency department central venous catheter insertions and enhances patient satisfaction.