Ultrasound-Guided Peripheral Venous Catheterization in Emergency Services

Abstract

Peripheral venous catheterization is difficult to achieve in some patients, which can delay diagnosis and treatment, causing problems for the patient and frustration for health professionals. 1 Miles G Salcedo A Spear D Implementation of a successful registered nurse peripheral ultrasound-guided intravenous catheter program in an emergency department. J Emerg Nurs. 2012; 38: 353-356 Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar Venous catheterization is one of the most frequently used techniques in emergency care settings. Nonetheless, catheter insertion has a 10% to 40% overall failure rate, 2 Leidel BA Kirchhoff C Bogner V et al. Is the intraosseous route fast and efficacious compared to conventional central venous catheterization in adult patients under resuscitation in the emergency department?. Patient Saf Surg. 2009; 3 (http://www.pssjournal.com/content/3/1/24. Accessed February 3, 2016): 24 Crossref PubMed Google Scholar and although attempts have been made to define the patient characteristics that contribute to the difficulty of cannulation, 3 Lapostolle F Catineau J Garrigue B et al. Prospective evaluation of peripheral venous access difficulty in emergency care. Intensive Care Med. 2007; 33: 1452-1457 Crossref PubMed Scopus (118) Google Scholar the only relationship that has been established is between certain disease conditions and the difficulty of intravenous (IV) access. Patients with diabetes or heart conditions have more fragile veins, 4 Walsh G Difficult peripheral venous access: recognizing and managing the patient at risk. J Assoc Vasc Access. 2008; 13: 198-203 Abstract Full Text Full Text PDF Scopus (39) Google Scholar and the patient’s clinical status, pain level, or state of anxiety can affect the difficulty of implementing this technique. 5 Yen K Riegert A Gorelick MH Derivation of the DIVA score: a clinical prediction rule for the identification of children with difficult intravenous access. Pediatr Emerg Care. 2008; 24: 143-147 Crossref PubMed Scopus (140) Google Scholar Other characteristics that affect IV catheterization in the general population are obesity or being underweight 6 Sebbane M Claret PG Lefebvre S et al. Predicting peripheral venous access difficulty in the emergency department using body mass index and a clinical evaluation of venous accessibility. J Emerg Med. 2013; 44: 299-305 Abstract Full Text Full Text PDF PubMed Scopus (117) Google Scholar and repeated venous administration of prescription drugs. 7 Fields JM Dean AJ Todman RW et al. The effect of vessel depth, diameter, and location on ultrasound-guided peripheral intravenous catheter longevity. Am J Emerg Med. 2012; 30: 1134-1140 Abstract Full Text Full Text PDF PubMed Scopus (54) Google Scholar Studies analyzing the ultrasound-guided catheterization technique have shown that a high percentage of the patients for whom this technique has been used have chronic diseases 8 Schoenfeld E Boniface K Shokoohi H ED technicians can successfully place ultrasound-guided intravenous catheters in patients with poor vascular access. Am J Emerg Med. 2011; 29: 496-501 Abstract Full Text Full Text PDF PubMed Scopus (55) Google Scholar or high body mass index. 9 Elia F Ferrari G Molino P et al. Standard-length catheters vs long catheters in ultrasound-guided peripheral vein cannulation. Am J Emerg Med. 2012; 30: 712-716 Abstract Full Text Full Text PDF PubMed Scopus (71) Google Scholar Laia Salleras-Duran is Registered Nurse, Emergency Department, Hospital of Figueres, Fundació Salut Empordà, Girona, Spain. Concepció Fuentes-Pumarola is Professor, Nursing Department, University of Girona, Girona, Spain. Núria Bosch-Borràs is Registered Nurse, Hospital of Figueres, Fundació Salut Empordà, Girona, Spain. Xavier Punset-Font is Registered Nurse, Hospital of Figueres, Fundació Salut Empordà, Girona, Spain. Francesc-Xavier Sampol-Granes is Registered Nurse, Hospital of Figueres, Fundació Salut Empordà, Girona, Spain.