Rapid Central Vein Assessment (RaCeVA): A systematic, standardized approach for ultrasound assessment before central venous catheterization

Abstract

Ultrasound technology has revolutionized the practice of safer vascular access, for both venous and arterial cannulation. The ability to visualize underlying structures of the chest, neck, and upper/lower extremities provides for greater success, speed, and safety with all vascular access procedures. Ultrasound not only yields superior procedural advantages but also provides a platform to perform a thorough assessment of the vascular structures to evaluate vessel health, viability, size, and patency, including the location of other important and best avoided anatomical structures-prior to performing any procedures. Such assessment is best performed using a systematic and standardized approach, as the Rapid Central Vein Assessment, described in this study.

Ultrasound‐guided anatomical evaluation of right internal jugular vein in children aged 0‐2 years: A prospective observational study

“…We did not apply the Trendelenburg position. We performed the evaluations using ultrasound as recommended by the RaCeVA protocol, the preprocedural standard systematic scanning of central veins using ultrasound, which begins first with the IJV in the mid‐neck level 3 . We aimed to identify the widest diameter of the RIJV and assessed the depth (D), the anterior‐posterior (AP) and transverse (T) diameters, as well as the RIJV's position in relation to the carotid artery (CA) at this level.…”

Right Assessment and Vein Selection

“…Scanning for peripheral veins and structures within the arms begins at the level of the forearm working toward the body. Optimal peripheral cannula site selection is one that allows ultrasound-guided needle access in a vein 2-4 mm in diameter or larger and 0.3-1.5 cm in depth (Witting et al 2010).…”

“…The RACEVA protocol uses ultrasound for thorough assessment of vascular structures in terms of size, patency and overal vialbility for catheterization. It also provides information on overall anatomy of the area do reduce inadvertant puncture of surrounding anatomic structures (Spencer and Pittiruti 2018). More information on ultrasound scanning and the RACEVA and RAPEVA methods are found in the references (Pittiruti 2012).…”

Curriculum for the Performance of Ultrasound‐Guided Procedures

“…Preprocedure assessment is critical to a safe cannulation. For central venous access, we strongly recommend applying the Rapid Assessment for Central Venous Access (RACEVA) Protocol . This formal 6‐point ultrasound evaluation, which can be performed in approximately 60 seconds, is used to evaluate the internal and external jugular veins and the brachiocephalic and axillary veins.…”