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Related Experiment Video

Updated: Feb 27, 2026

Author Spotlight: Evaluating Clinicians' Adoption of Ultrasound-Guided Vascular Cannulation Through Simulation Training
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Increasing First-Attempt Success in Difficult Venous Access Patients Using Early Identification and Ultrasound-Guided

Alirio A Olmedo, Catherine P Canamar

    Journal of Emergency Nursing
    |February 26, 2026
    PubMed
    Summary
    This summary is machine-generated.

    Implementing the adult difficult intravenous access scale improved flagging and first-attempt success for intravenous catheter insertion in emergency departments. This led to better patient care by reducing treatment delays.

    Keywords:
    Advanced cannulation techniquesDifficult venous accessFailurePeripheral intravenous catheterUltrasound-guided peripheral intravenousVenous accessVenous access assessment

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    Area of Science:

    • Emergency Medicine
    • Vascular Access Procedures

    Background:

    • Difficult venous access in emergency departments leads to failed IV attempts and treatment delays.
    • A need exists to improve identification and management of patients with challenging venous access.

    Purpose of the Study:

    • To enhance the flagging of patients with difficult venous access.
    • To increase first-attempt intravenous catheter insertion success in adult emergency department patients.

    Main Methods:

    • A consecutive cohort study compared standard methods with the adult difficult intravenous access scale.
    • The implementation cohort (n=2005) used the scale, with high-risk patients receiving ultrasound-guided cannulation.
    • The comparator cohort (n=2016) used standard venous access assessment.

    Main Results:

    • The adult difficult intravenous access scale increased difficult venous access flagging from 2% to 10%.
    • First-attempt intravenous success rose from 33% to 41% overall.
    • In the implementation cohort, 97% of patients with difficult venous access achieved first-attempt catheter insertion.

    Conclusions:

    • Combining the adult difficult intravenous access scale with ultrasound-guided cannulation significantly improves difficult venous access flagging and first-attempt success.
    • This approach led to an 8% absolute increase in both flagging and success rates.
    • Demonstrated a 400% relative improvement in difficult venous access flagging and a 24% increase in first-attempt success.