Ultrasound-guided peripheral intravenous access in adults: A randomized crossover controlled trial

Area of Science:

• Medical Ultrasound
• Vascular Access
• Emergency Medicine

Background:

• Difficult peripheral intravenous access is a frequent challenge in emergency and critical care.
• It compromises timely treatment, patient safety, and increases healthcare costs.
• Repeated cannulation attempts strain nursing staff and resources.

Purpose of the Study:

• To develop an evidence-based ultrasound-guided peripheral intravenous access protocol.
• To evaluate the efficacy of ultrasound guidance for difficult intravenous access.

Main Methods:

• A randomized crossover study involving 36 adult volunteers with difficult venous access.
• Comparison of ultrasound-guided versus traditional blind peripheral intravenous access.
• Utilized a high-frequency ultrasound probe with a two-person scanning technique.

Main Results:

• Ultrasound guidance dramatically improved first attempt success rates (OR=10.97, p<0.0001).
• Overall success rates were significantly higher with ultrasound (OR=49.67, p<0.0001).
• The number of attempts was reduced by an average of 0.50 (p<0.0001).

Conclusions:

• An ultrasound-guided protocol effectively improves peripheral intravenous access in challenging cases.
• Recommends a two-person scanning method and rigorous training for clinical implementation.
• Addresses difficult access issues, reduces nursing burden, and enhances care quality.