Handheld Ultrasound: Overcoming the Challenge of Difficult Peripheral Intravenous Access in the Emergency Department.

TitleHandheld Ultrasound: Overcoming the Challenge of Difficult Peripheral Intravenous Access in the Emergency Department.
Publication TypeJournal Article
Year of Publication2020
AuthorsAcuña J, Sorenson J, Gades A, Wyatt R, Stea N, Drachman M, Adhikari S
JournalJ Ultrasound Med
Date Published2020 Oct
ISSN Number1550-9613
KeywordsCatheterization, Peripheral, Emergency Service, Hospital, Humans, Reproducibility of Results, Retrospective Studies, Ultrasonography, Interventional

OBJECTIVES: The purpose of this study was to evaluate the performance of a handheld ultrasound device for difficult peripheral intravenous (PIV) access performed by nurses and paramedics in the emergency department (ED).

METHODS: This was a retrospective review at an academic medical center. Participants were ED nurses and paramedics with competence in ultrasound-guided PIV placement. Participants were asked to log their use of the handheld device when used on patients deemed to have "difficult" access and complete a questionnaire, which consisted of items related to the effectiveness and ease of use of the device. Data were collected over the course of 1 year. An electronic medical record review was performed to track the success rates and the occurrence of any associated complications throughout the hospital stay.

RESULTS: Nurses and paramedics logged a total of 483 cases in which PIV access was attempted with the handheld ultrasound device. Ninety-two percent (95% confidence interval [CI], 89%-94%) of the ultrasound-guided PIV lines attempted were placed successfully. Eighty-four percent (95% CI, 80%-87%) of the lines were placed successfully on the first attempt. In most cases (396 of 483 [82%]), no complications associated with the PIV occurred. A total of 429 questionnaires were completed over the study period. Most of the operators (84%; 95% CI, 80%-87%) stated that the handheld device was adequate to perform ultrasound-guided PIV access.

CONCLUSIONS: The handheld ultrasound device performed well in terms of usability and reliability for PIV access.

Alternate JournalJ Ultrasound Med
PubMed ID32333616
Grant List / / the Society /
Faculty Reference: 
Josie G. Acuña, MD
Srikar Adhikari, MD, MS, FACEP
Maili Drachman, MD
Nicholas J. Stea, MD