Piloting a nurse-led ultrasound cannulation scheme

Abstract

Intravenous therapy has evolved to form a fundamental cornerstone of modern health care, but there are significant groups of patients in whom obtaining peripheral venous access is a difficult and drawn out process. An ultrasound guided peripheral venous access service could potentially stop multiple 'blind' attempts, and subsequent damage. A pilot scheme to look at nurse-led ultrasound cannulation was established, and its early results are presented in this article. In addition, a one-operator technique of peripheral ultrasound guided cannulation is described. A total of 28 different patients were referred on 34 occasions for ultrasound guided peripheral cannulation. A total of 33 cannulae were inserted with an overall success rate of 97%. An average of 6.4 attempts at cannulation were undertaken prior to referral and an average of 1.3 attempts were needed to place a cannula under ultrasound guidance. Sixty-nine percent of the cannulae were inserted into the veins of the anterior forearm and 12% into the basilic veins. Overall, 2D ultrasound guided peripheral cannulation is a reliable technique for obtaining vascular access on any adult patients who have already undergone multiple cannulation attempts or in those who it is thought cannulation may be difficult.