Ultrasound boosts clinicians’ success rates in inserting IVs

Children’s Hospital of Philadelphia is using ultrasound technology to guide placement of IV lines in children with presumed difficult access, such as veins that are too small.

By using ultrasound, children are being spared multiple attempts by clinicians to insert IV lines, and the clinicians are experiencing higher success rates on insertion on the first attempt.

Alexandra Vinograd
Alexandra Vinograd, MD

Research shows that the children and their families are happier with ultrasound-guided line insertion, according to Alexandra Vinograd, MD, an emergency physician at the hospital. “The need to place an intravenous line is a common but challenging requirement for pediatric healthcare providers,” she adds.

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Researchers enrolled 167 patients with difficult IV access, and the study also included a control group of patients. Selection of patients ws randomized to receive either traditional IV line or being served by a team trained to place ultrasound-guided IV lines on the first attempt.

Among participating physicians, first-attempt was higher in the in ultrasound-guided IV placement group at an 85 percent success rate, compared with only 46 percent success for the group using traditional methods to start intravenous lines.

Further, ultrasound-guided lines remained in place longer than traditional lines with no increase in complications, says Joseph Zorc, MD, an emergency medicine physician and senior author of the study.

Vinograd notes that both nurses and physicians experienced higher rates of success on first attempt insertions. That success led to a training program for in the emergency department for nurses doing ultrasound-guided IV placement. “Ultrasound-guided access is now standard procedure for children with presumed difficult intravenous access,” she adds.

The full study is published in the July volume of the Annals of Emergency Medicine.

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