{"id":1910,"date":"2020-11-25T08:00:00","date_gmt":"2020-11-25T08:00:00","guid":{"rendered":"https:\/\/emultrasound.sdsc.edu\/?p=1910"},"modified":"2021-05-04T16:58:23","modified_gmt":"2021-05-04T16:58:23","slug":"peripheral-iv","status":"publish","type":"post","link":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/11\/25\/peripheral-iv\/","title":{"rendered":"A Practical Guide to Placing Ultrasound-Guided Peripheral IVs"},"content":{"rendered":"
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Background<\/h2>\n

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Peripheral IV placement is one of the most common procedures performed in hospitals, with hundreds of millions performed each year. For the most part, IVs are successfully placed in the traditional way - using landmarks and visualization\/palpation of the vessels. But as we all know, there are several patient factors that can make peripheral IV placement more difficult, including obesity, edema, a history of IV drug use, sickle cell disease, lupus, diabetes, etc.<\/p>\n

Ultrasound-guided IV placement is increasingly used in the emergency room, medicine floors and ICUs in patients with difficult IV access, but  the research is clear that there is a higher premature failure rate with ultrasound-guided IVs (1). <\/p>\n

This practical guideline details several considerations that may help reduce the premature failure rate of ultrasound-guided IV catheter placement.  <\/p>\n

 <\/p>\n

Ultrasound-Guided Peripheral Venous Cannulation in Critically Ill Patients: a Practical Guideline<\/a><\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n

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Clinical Question<\/h3>
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What are key concepts to help reduce ultrasound guided peripheral IV catheter complications, prolong life of catheters, and increase rate of successful placement?<\/span><\/p>\n<\/div><\/div>\n

Methods & Study Design<\/h3>
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\u2022 Design\u00a0<\/b><\/span><\/p>\n

Review paper<\/span><\/p>\n<\/div><\/div>\n

Results<\/h3>
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There are six key concepts to help minimize complications and increase duration of ultrasound-guided peripheral IV catheter placement.<\/span>\"\"<\/p>\n<\/div><\/div>\n

Strength & Limitations<\/h3>
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Potential limits to these guidelines include ultrasound experience level of a person placing IV catheters, whether the necessary equipment is routinely available at lower resource centers, and the setting in which IV cannulation takes place (e.g. trauma or non-trauma). The access and cost of ultra-long peripheral and midline catheters may limit use given potential for high utilization.\u00a0<\/span><\/p>\n<\/div><\/div>\n

Authors Conclusion<\/h3>
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\u201c<\/span>Practitioners should consider several issues when inserting intravenous peripheral catheters under ultrasound guidance, aiming to improve success rate, avoid complications and lengthen the survival of the catheter. Based on available data and everyday practice, all indicate that catheters longer than standard size are needed for US-guided peripheral venous cannulation, with the purpose of minimizing premature catheter failure. This is a call for attention to catheter manufacturers, since a more affordable solution at hand is expected from them shortly.\u201d<\/span><\/p>\n<\/div><\/div>\n

Our Conclusion<\/h3>
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For placement of ultrasound-guided peripheral IVs consider these rules:<\/p>\n