Ultrasound-guided Peripheral Intravenous Insertion Research Articles

Outcomes of a Comprehensive Ultrasound Guided Peripheral IV Insertion (USGPIV) Training Program in a Pediatric Emergency Department

IntroductionTimely and reliable peripheral intravenous cannulation is an imperative skill in a pediatric emergency department. Utilization of point-of-care ultrasound guidance has proven to significantly improve first-attempt peripheral intravenous cannulation insertion rates in pediatric patients. We sought to develop, implement, and evaluate an ultrasound-guided peripheral intravenous training program for emergency nurses in a tertiary care pediatric center. MethodsTwelve emergency nurses underwent a training program that consisted of an interactive asynchronous learning module followed by 8 hours of training by a vascular access clinical instructor. Data was collected on each ultrasound-guided peripheral intravenous insertion via survey methodology. ResultsComplete data for a total of 210 ultrasound-guided peripheral intravenous were recorded over the 9-month period. A total of 65.2% (137/210) of patients who received an ultrasound-guided peripheral intravenous had known difficult intravenous access on history. A total of 89.5% (188/210) of patients had a difficult intravenous access of ≥4. The mean difficult intravenous access score for the patients in which ultrasound-guided peripheral intravenous insertions were attempted was 4.78 (95% confidence interval, 4.55-5.01). A total of 193 of 210 (91.9%) of ultrasound-guided peripheral intravenous were attained successfully. On the first attempt, 86.5% (167/193) ultrasound-guided peripheral intravenous were attained, and 98.96% (191/193) were attained within the first 2 attempts. ConclusionWe found that implementing a comprehensive ultrasound-guided peripheral intravenous training program for emergency nurses in a pediatric tertiary care center led to a high first-pass success rate in attaining peripheral intravenous cannulations. It also facilitates vascular access in patients with known difficult intravenous access. Consideration should be made to implementing point-of-care ultrasound intravenous training programs to improve pediatric vascular access in the emergency department, particularly in patients with known difficult intravenous access.

Using Ultrasound-guided PIV Insertion in the Pediatric Population to Decrease Insertion Attempts

Intravenous (IV) therapy using a peripheral IV (PIV) in children is a medical intervention frequently used in hospitals. Current evidence supports ultrasound-guided PIV placement in the adult patient population. The purpose of this study was to implement an evidence-based practice approach to determine if ultrasound-guided IV insertion decreased the number of attempts for successful cannulation and improved staff and patient satisfaction with the treatment in the pediatric inpatient population. Data collection was conducted in a pediatric medical surgical unit and pediatric intensive care unit (PICU). After the implementation of ultrasound-guided IV insertion, the average number of attempts necessary for successful insertion decreased from 2 to 1.37. Findings support the integration of ultrasound-guided IV insertion into the standard of care on pediatric medical surgical units and PICUs.