Health System Impact of Emergency Department-Based Vascular Access Program in Patients with Difficult Intravenous...

Area of Science:

• Emergency Medicine
• Vascular Access
• Point-of-Care Ultrasound (POCUS)

Background:

• Ultrasound-guided peripheral intravenous (PIV) access is a critical application of point-of-care ultrasound (POCUS).
• It significantly reduces time to access, minimizes the need for invasive procedures, preserves patient vasculature, and enhances the overall patient experience.

Purpose of the Study:

• To describe the impact of an Emergency Department (ED)-based vascular access program utilizing a specialized team of paramedics and emergency medical technicians (EMTs).
• To highlight the team's training in ultrasound-guided PIV access for patients with difficult intravenous access (DIVA) within the ED and the broader academic medical center.

Main Methods:

• This descriptive report details the implementation, development, and evolution of a specialized vascular access team at a single academic center.
• The team, comprising ED paramedics and EMTs, received comprehensive training and oversight in ultrasound-guided PIV placement under the guidance of EM ultrasound faculty.
• The report covers program description, patient selection criteria, and billing capture, meeting Institutional Review Board exemption for a quality improvement project.

Main Results:

• Formation and maintenance of a highly skilled vascular access team.
• Paramedics and EMTs trained in ultrasound-guided PIV placement effectively manage patients with DIVA.
• Development of a tiered approach to vascular access and preservation across the organization.

Conclusions:

• The established vascular access team enhances patient care by providing expert ultrasound-guided PIV placement.
• This program benefits both patients and hospital staff through improved vascular access and preservation strategies.
• The initiative demonstrates a successful quality improvement project in emergency medicine ultrasound utilization.