Abstract
Introduction: Peripheral intravenous cannulation (PIVC) is a universal procedure to get venous access in hospital emergency settings. Sometimes, for critically ill patients in an emergency department, when we cannot get peripheral venous access, a central venous access could be established by percutaneous subclavian vein cannula insertion through a supraclavicular approach. This study will compare PIVC and percutaneous subclavian vein cannula insertion through supraclavicular approach, and determine which method is more effective and fast in critically ill patients arriving in the emergency department.Methods: This prospective, randomized clinical trial involved a total of 98 patients arriving in the emergency department in critical condition. Percutaneous subclavian vein cannula insertion through supraclavicular approach was attempted in 49 patients, and PIVC was attempted in other 49 patients. The timing of cannula insertion and the number of attempts for successful cannulation were compared for the two methods.Results: Percutaneous subclavian vein cannula insertion through supraclavicular approach was successful in 47 out of 49 patients (96%), and PIVC was successful in 38 out of 49 patients (78%). Average time of percutaneous subclavian vein cannula insertion through supraclavicular approach was 27.7 seconds (range 15-90 seconds), and the average time of PIVC was 68.64 seconds (range 25-150 seconds).Conclusion: Compared with PIVC, percutaneous subclavian vein cannula insertion through supraclavicular approach is faster and more effective to gain venous access in critically ill patients arriving in emergency department.
Highlights
Peripheral intravenous cannulation (PIVC) is a universal procedure to get venous access in hospital emergency settings
Percutaneous subclavian vein cannula insertion through supraclavicular approach was attempted in 49 patients, and PIVC was attempted in other 49 patients
The study included a total of 98 patients, with percutaneous subclavian vein cannula insertion through a supraclavicular approach attempted in 49 patients and peripheral IV cannula insertion attempted in the other 49 patients
Summary
Peripheral intravenous cannulation (PIVC) is a universal procedure to get venous access in hospital emergency settings. For critically ill patients in an emergency department, when we cannot get peripheral venous access, a central venous access could be established by percutaneous subclavian vein cannula insertion through a supraclavicular approach. This study will compare PIVC and percutaneous subclavian vein cannula insertion through supraclavicular approach, and determine which method is more effective and fast in critically ill patients arriving in the emergency department. Sometimes in emergency department, when one can not get peripheral venous access due to some reason like shock, a central venous access could be established effectively and in short time by percutaneous subclavian vein cannula insertion through supraclavicular approach.
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