Related Experiment Video
Updated: Jul 16, 2026
Using Simulation Models to Train Clinicians in the Use of Point-of-Care Ultrasound
Published on: August 9, 2024
A pilot study of ultrasound analysis before pediatric peripheral vein cannulation attempt
David Schnadower1, Sophia Lin, Phillips Perera
1Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Medical Center, New York, NY, USA. ds2194@columbia.edu
Insights
Ultrasound (US) can detect peripheral veins in young children, improving peripheral venous catheterization success rates. Vein length identified by US is a key predictor of successful cannulation.
Area of Science:
- Pediatric Emergency Medicine
- Medical Ultrasound
- Vascular Access
Background:
- Peripheral venous (PV) catheterization is crucial in pediatric emergency care.
- Difficult venous access is common in young children, leading to delayed treatment.
- Ultrasound (US) may offer a solution for visualizing veins in challenging cases.
Purpose of the Study:
- To assess the efficacy of US in detecting peripheral veins in children younger than 7 years.
- To identify US-measured vein characteristics associated with successful PV catheterization.
Main Methods:
- Observational study in a pediatric emergency department.
- Inclusion of children younger than 7 years undergoing PV catheterization attempts.
- Vein assessment using US (transverse and longitudinal views) and clinical appearance.
- Correlation of US measurements with catheterization success rates.
Main Results:
- US detected all clinically apparent veins (90/90) with a 69% success rate.
- US detected 10% of non-clinically apparent veins, with a 10% success rate.
- Maximal vein length in longitudinal view independently predicted cannulation success.
Conclusions:
- US is effective in detecting peripheral veins in young children.
- Lack of US visualization correlates with failed PV placement.
- Greater vein length is a valuable predictor for successful peripheral venous catheterization.
Objectives:
To determine whether peripheral veins can be detected by ultrasound (US) and to determine vein characteristics, as measured by US, that are associated with successful peripheral venous (PV) catheterization in young children.
Methods:
The authors conducted an observational study in the pediatric emergency department (ED), with a convenience sample of children younger than 7 years. They evaluated attempts at PV catheterization in two groups on the basis of the visibility and palpability of the patients' veins: 1) clinically apparent (visible or palpable) and 2) not clinically apparent (nonvisible and nonpalpable). The authors obtained sonographic measurements in a transverse view (vertical diameter, circumference, and area) and in a longitudinal view (maximal uninterrupted length). Practitioners blinded to the US images then attempted to catheterize veins in the usual manner. The proportion of clinically apparent veins and the proportion of veins that were successfully catheterized that were identified by US were assessed, and the association between ultrasonographic vein measurements and success at catheterization, controlling for possible confounders, was determined.
Results:
The authors assessed 120 attempts (90 clinically apparent and 30 not clinically apparent) at PV catheterization in 83 patients. US detected all 90 clinically apparent veins, and cannulation success rate was 62/90 (69%). In the not clinically apparent vein group, the rate of success was only 3/30 (10%), and US detected all successfully catheterized veins. In no instance was cannulation successful when the vein was not detected by US. Maximal vein length in longitudinal view was an independent predictor of cannulation success in multivariate analysis.
Conclusions:
Ultrasound appears to be capable of detecting peripheral veins in children younger than 7 years of age, with lack of US vein visualization likely leading to unsuccessful PV placement. Greater vein length visualization may be a useful predictor of successful PV catheterization.
Related Concept Videos
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:19Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment: