Peripherally inserted central catheter placement with the sonic flashlight: initial clinical trial by nurses

Area of Science:

• Vascular Access Procedures
• Medical Device Technology
• Ultrasound Guidance

Background:

• Peripherally inserted central catheters (PICCs) require precise placement for long-term intravenous access.
• Ultrasound guidance is increasingly used to improve the safety and efficacy of PICC insertion.
• Novel devices aim to enhance the user experience and accuracy of ultrasound-guided procedures.

Purpose of the Study:

• To evaluate the safety and effectiveness of the sonic flashlight (SF) as an ultrasound guidance tool for PICC placement.
• To compare the performance of the SF with conventional ultrasound (CUS) in terms of needle punctures required for venous access.
• To gather user feedback from experienced intravenous (IV) team nurses on the SF device.

Main Methods:

• A case series involving two experienced IV team nurses performing PICC insertions.
• Two ultrasound guidance methods were employed: conventional ultrasound (CUS; 60 patients) and the sonic flashlight (SF; 44 patients).
• The primary outcome measured was the number of needle punctures needed to achieve successful venous access.

Main Results:

• Both SF and CUS achieved successful venous access on the first attempt in 87% of cases.
• The average number of needle sticks per patient was nearly identical: 1.18 for SF versus 1.20 for CUS.
• Nurses reported the SF display was comparatively easy to use, but noted its smaller image scale than CUS.

Conclusions:

• The sonic flashlight (SF) is a safe and effective alternative for ultrasound-guided PICC placement by experienced nurses.
• The SF's advantage of locating the ultrasound image at the actual insertion site is a key feature.
• The relatively small image scale of the SF is a consideration that needs to be weighed against its benefits.