A Randomized Study of Biplane Imaging in Ultrasound-Guided Peripheral Vascular Access Performed by Novice Operators

Area of Science:

• Medical Education
• Emergency Medicine
• Ultrasound Technology

Background:

• Ultrasound guidance enhances safety and success in vascular access.
• Traditional ultrasound offers short- or long-axis views, each with pros and cons.
• Biplane ultrasound technology allows simultaneous visualization of both short and long axes.

Purpose of the Study:

• To evaluate if the biplane ultrasound approach improves competency in ultrasound-guided peripheral intravenous (USGIV) catheter placement.
• To assess the impact of biplane imaging on medical student trainees' USGIV skills.

Main Methods:

• Randomized trial of medical students on emergency medicine rotation from November 2022 to February 2024.
• Comparison between biplane ultrasound and traditional ultrasound guidance for USGIV placement using phantom models.
• Outcomes measured: perceived difficulty, time to placement, needlesticks, and posterior wall punctures.

Main Results:

• 98 students (51 biplane, 47 traditional) participated.
• No significant difference in time to placement (64.4s vs 73s, p=0.29) or needlesticks (1.10 vs 1.06, p=0.65).
• Biplane group showed a significant reduction in posterior wall punctures (0.14 vs 0.45, p=0.019).

Conclusions:

• Biplane imaging did not reduce time to USGIV placement in novice medical students.
• The biplane approach was associated with a significant decrease in posterior wall punctures.
• Biplane ultrasound may enhance procedural safety for USGIV placement in trainees.