A Pilot Study of Ultrasound Analysis before Pediatric Peripheral Vein Cannulation Attempt

Abstract

Ultrasound appears to be capable of detecting peripheral veins in children younger than 7 years of age, with lack of US vein visualization likely leading to unsuccessful PV placement. Greater vein length visualization may be a useful predictor of successful PV catheterization.

Bedside ultrasound in pediatric critical care: A review

“…In the first study of 44 children by Bair et al (32), ultrasound by pediatric emergency medicine faculty allowed visualization of PIVs, but there was no difference in overall success rates or in first-attempt success rates. A study by Schnadower et al (33) also showed that ultrasound by pediatric emergency medicine faculty allowed visualization of peripheral veins, and additionally that lack of ultrasound visualization predicted failure of PIV placement through standard non-ultrasound-based methods by individuals blinded to ultrasound results. Finally, in a prospective randomized study of patients <10 yrs old with either a history of difficult venous access or two unsuccessful attempts at PIV placement through traditional means, Doniger et al (34) showed that ultrasound improved the success rate (80% with ultrasound use vs. 64% with traditional means) of a peripheral intravenous catheter in fewer attempts (median, one attempt with ultrasound use vs. three attempts with traditional means) and less time (6.3 mins with ultrasound use vs. 14.4 mins with traditional means).…”

Point-of-Care Ultrasound for the Evaluation and Management of Febrile Infants

“…26,27 In addition, US guidance may assist in identifying longer veins more likely to be successfully catheterized, and US-guided lines survive longer than traditional ones. 27,28 Typically, dynamic real-time procedural guidance is used to visualize the needle entering the vessel, but users with less POCUS procedural experience may also benefit from static US-assisted IV cannulation. In this approach, the site, approximate depth, and angle of approach are determined by POCUS, the needle insertion site is marked on the skin, and the vein is cannulated without dynamic US guidance.…”

“…In addition, US-guided peripheral IV access has been shown to result in fewer attempts, fewer needle redirections, and shorter time to successful access when compared with traditional palpation techniques 26,27 . In addition, US guidance may assist in identifying longer veins more likely to be successfully catheterized, and US-guided lines survive longer than traditional ones 27,28 . Typically, dynamic real-time procedural guidance is used to visualize the needle entering the vessel, but users with less POCUS procedural experience may also benefit from static US-assisted IV cannulation.…”

AIUM Practice Parameter for the Use of Ultrasound to Guide Vascular Access Procedures

“…The static approach has advantages over a completely landmark‐guided procedure. However, the dynamic approach allows for real‐time visualization of needle tip placement and has been shown to be superior to the static approach in most situations …”

“…However, the dynamic approach allows for real-time visualization of needle tip placement and has been shown to be superior to the static approach in most situations. 10…”