Ultrasonographically Guided Insertion of a 15-cm Catheter Into the Deep Brachial or Basilic Vein in Patients With Difficult Intravenous Access

The effect of vessel depth, diameter, and location on ultrasound-guided peripheral intravenous catheter longevity

“…4,5 However, ultrasound-guided peripheral IVs (USGPIVs) suffer from a failure rate of up to 8% in the first hour after placement and 47% within the first 24 hours after placement. 4,6,7 This is much higher than traditionally placed IVs, which have reported failure rates of only 6-32% after three days. 8,9 Dislodgement of an IV has the potential to threaten patient safety by interrupting delivery of medications and fluids and putting patients at risk of extravasation that can lead to ischemia and/or tissue necrosis.…”

“…The only study to cast light on this issue, the one by Mills et al, supports the notion that short catheter length may be a cardinal flaw in deeper vessels. 6 In that study a standard length catheter was used to cannulate the vein, but this was immediately followed by placement of a 15 cm long catheter over a guide wire. The only catheter of 24 subsequently to fail (median duration of catheter survival 26 hours) did so after 15…”

Ultrasonography-Guided Peripheral Intravenous Access: Regular Technique Versus Seldinger Technique in Patients with Difficult Vascular Access

“…A previous study (5) reported an eight percent failure rate in the first hour after US-guided placement of a 5-cm catheter, which is slightly longer than the catheter used in our study (4.4-cm). Taking this observation into consideration, Mills et al (7) hypothesized that standard length USguided catheters (3-5 cm in length) may be too short to adequately reach the lumen of deeper peripheral veins and therefore tend to be easily dislodged. In the Seldinger technique group, there was one case (4.4%) of early infiltration and no cases of later infiltration.…”

“…However, its drawbacks, are that intravenous catheters may dislodge and intravenous fluid infiltrates because standard length catheters may not extend far enough into the vein lumen. Mills et al (7) reported that ultrasonographically guided insertion of a 15-cm catheter into the deep brachial or basilic vein offers a potentially safe and rapid alternative to central line placement in adult patients with difficult intravenous access. We sought to compare US-guided PIV access by regular technique using standard catheters with Seldinger technique using central venous catheters.…”

Peripheral Intravenous Access Using Ultrasound Guidance: Defining the Learning Curve

“…6,7 Prior studies have demonstrated similar success rates for nurses compared with other practitioners: These studies reported a success rate at first attempt ranging from 56% to 97% for emergency department physicians, 74% for nurse anesthetists, 75% to 81% for emergency department technicians, and 44% to 87% for emergency department RNs. 5,[8][9][10][11][12][13][14][15] Time to successful cannulation on first attempt was variable among physicians, ranging from a few minutes to about an hour. 6,[8][9][10][11] The number of attempts before achieving successful cannulation for emergency department physicians ranged from 1.3 to 3, and for emergency department technicians the range was 1.3 to 2.3.…”