Comparing the Efficacy of Peripheral Vessel Cannulation Assistance Utilizing Point Localization and Pathway...

Area of Science:

• Medical Devices
• Ultrasound Technology
• Vascular Access

Background:

• First-pass peripheral intravenous catheter (PIVC) insertion failure rates can be as high as 40%, often due to challenges in vein localization.
• Successful subsequent attempts heavily rely on accurate vein identification, especially in patients with difficult intravenous access (DIVA).

Purpose of the Study:

• To evaluate a novel ultrasound device featuring coronal pathway visualization for enhancing PIVC insertion accuracy.
• To compare the efficacy of this device against traditional point localization (single ultrasound frame) in untrained users.

Main Methods:

• A benchtop study involved 14 untrained investigators performing PIVC insertions into phantom models.
• Utilized pathway visualization and point localization techniques, collecting data on first-attempt success rates, cannula tip-to-vessel distance, and angle alignment.
• Investigated user factors like cannulation familiarity and grip technique to inform prototype development.

Main Results:

• Pathway visualization yielded a higher first-pass success rate (85.7%) compared to point localization (71.4%), effectively halving failure rates.
• Significantly improved accuracy was observed with pathway visualization regarding cannula tip-to-vessel distance (1.91 mm vs. 4.21 mm, p < .004) and angle alignment (3.49° vs. 12.50°, p < .001).

Conclusions:

• Coronal pathway visualization significantly enhances PIVC placement accuracy, success rates, and needle-to-vessel alignment compared to point localization.
• The device holds potential for improving cannulation success in DIVA patients.
• Further research is needed to compare coronal pathway visualization with traditional transverse visualization (handheld ultrasound).