Ultrasound assessment of peripheral intravenous catheters by nurses in the pediatric intensive care unit
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Updated: Nov 2, 2025

The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
Published on: December 23, 2014
Ryan J Good1, Elizabeth Diaz2, Robin Thomas2
1Department of Pediatrics, Section of Critical Care, University of Colorado at Denver, Anschutz Medical Campus, Aurora, CO, USA.
Objective:
Establish the feasibility of pediatric intensive care unit (PICU) nurse-directed ultrasound assessment (UA) of peripheral intravenous (PIV) catheters, compare the results of UA to traditional assessment (TA), and determine PIV survival after UA.
Design:
Prospective observational cohort study.
Setting:
PICU within a children's hospital.
Patients:
PICU patients with a PIV.
Interventions:
None.
Measurements And Main Results:
Eight nurses performed UA on 131 PIVs in 85 patients. Median age was 3.0 years (IQR 1.0-13.8) and median weight was 15.0 kg (IQR 9.6-59.3). The most common PIV location was the arm (43%) and extravasation occurred in 15% of PIVs. Agreement between TA and UA was moderate with a Kappa of 0.47 (95% CI 0.28-0.66). Nursing confidence in the UA was significantly higher than TA (92% vs 21% very confident, p < 0.0001). In 106 PIVs with a UA that indicated the PIV was intravascular (i.e. negative UA), the median survival was 50.0 h (IQR 21.8-100.3).
Conclusions:
Nurses can perform UA of PIV status in PICU patients and express greater confidence in the findings of UA than TA. Further study is necessary to determine the impact of UA on the rate of PIV complications.
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