Prospective evaluation of ultrasound-guided short catheter placement in internal jugular veins of difficult venous access patients

Peripheral intravenous catheter placement is a skill that is used daily in the hospital. However, many nurses face the challenge of cannulating increasingly complex and difficult-to-access vasculature. Although emergency department clinicians have been using ultrasound to facilitate this procedure for the last 18 years, ultrasound-guided peripheral intravenous catheter placement has not been as rapidly adopted in the critical and acute care nursing realms. Given the benefits of this procedure, including increased patient satisfaction and reduced use of central catheters, its use should be encouraged among all acute care clinicians. The aim of this article is to provide the bedside nurse with a basic understanding of the techniques involved in placing ultrasound-guided peripheral intravenous catheters in patients with difficult venous access.

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Nurse-performed Ultrasound-guided Upper Extremity Venous Cannulation in Emergency Department Patients with Difficult Venous Access

Academic Emergency Medicine ◽

10.1197/j.aem.2005.03.090 ◽

2005 ◽

Vol 12 (Supplement 1) ◽

pp. 35-35 ◽

Cited By ~ 2

Author(s):

B. F. Chinnock

Keyword(s):

Emergency Department ◽

Upper Extremity ◽

Venous Access ◽

Venous Cannulation ◽

Ultrasound Guided ◽

Emergency Department Patients ◽

Difficult Venous Access

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Midline catheter placement in an obese patient with difficult venous access

Medicine: Case Reports and Study Protocols ◽

10.1097/md9.0000000000000009 ◽

2020 ◽

Vol 1 (1) ◽

pp. e0009

Author(s):

Daisuke Tsuji ◽

Hiromu Okano ◽

Joho Tokumine ◽

Alan Kawarai Lefor ◽

Shogo Ema ◽

...

Keyword(s):

Obese Patient ◽

Venous Access ◽

Catheter Placement ◽

Difficult Venous Access

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Bleeding Complications in Ultrasound-Guided Central Venous Access in Patients with Severe Thrombocytopenia: A Propensity Score-Based Analysis

10.21203/rs.3.rs-809745/v1 ◽

2021 ◽

Author(s):

Virginia Zarama ◽

Jorge A. Revelo-Noguera ◽

Jaime A. Quintero ◽

Ramiro Manzano ◽

Francisco L. Uribe-Buriticá ◽

...

Keyword(s):

Logistic Regression ◽

Platelet Count ◽

Platelet Transfusion ◽

Central Venous Access ◽

Venous Access ◽

Catheter Placement ◽

Bleeding Complications ◽

Severe Thrombocytopenia ◽

Ultrasound Guided ◽

Central Venous

Abstract Purpose: To study the occurrence of bleeding complications in patients with severe thrombocytopenia (platelet count <20x103/µL) subjected to ultrasound-guided central venous access (UG-CVA) while receiving or not routine prophylactic platelet transfusion (PPLT).Research Question: What is the frequency of bleeding complications related to the placement of ultrasound-guided central venous access in patients with severe thrombocytopenia between 2011 and 2019 at high complexity hospital?Methods: A total of 221 patients with severe thrombocytopenia subjected to UG-CVA from January 2.011 to November 2.019 were selected. They were classified as positive (P-PPLT) or negative (N-PPLT) recipients of PPLT. Then, P-PPLT (n=72) were 1:1 propensity matched to N-PPLT based on catheter diameter, anatomical insertion site, presence of hematologic malignancy, absolute platelet count and whether the health care provider performing the procedure was an attending or a trainee. Bleeding complications were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) score and adapted to central venous catheter placement. A logistic regression analysis was then performed using “bleeding complications” as a binary compound outcome of major (Grades 3-4) and minor bleeding (Grades 1-2) vs. no bleeding.Results: Seventy-two patients were classified as P-PPLT, while 149 as N-PPLT. No grades 3-4 of bleeding events were identified in the entire population. No significant differences were observed between N-PPLT and P-PPLT for bleeding Grades 1-2 in both pre-matched (53[35.5%] vs. 26[36.1%], p=0.90) and propensity-matched populations (27[37.5%] vs. 26[36.1%], p=0.80). Logistic regression demonstrated that PPLT did not influence any bleeding complication (OR 0.9, 95%CI 0.42-1.92, p=0.791)Conclusions: Bleeding complications related to central venous catheterization in acutely ill patients with severe thrombocytopenia are not influenced by routine prophylactic platelet transfusion when catheter placement is performed under ultrasound guidance.

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Ultrasound‐guided techniques for peripheral intravenous placement in children with difficult venous access

Pediatric Anesthesia ◽

10.1111/pan.13780 ◽

2019 ◽

Vol 30 (2) ◽

pp. 108-115 ◽

Cited By ~ 3

Author(s):

Farrukh Munshey ◽

Dimitri A. Parra ◽

Conor McDonnell ◽

Clyde Matava

Keyword(s):

Venous Access ◽

Ultrasound Guided ◽

Difficult Venous Access

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Ultrasound-guided percutaneous right brachiocephalic vein cannulation in a 5-year-old patient with bilaterally occluded internal jugular veins due to previous access by venous cut-down: A case report

The Journal of Vascular Access ◽

10.1177/11297298211011883 ◽

2021 ◽

pp. 112972982110118

Author(s):

Filiz Uzumcugil

Keyword(s):

Venous Access ◽

Term Treatment ◽

Brachiocephalic Vein ◽

Central Vein ◽

Ultrasound Guided ◽

Central Venous ◽

Jugular Veins ◽

Assessment Protocol ◽

Long Term Treatment

The open surgical venous cut-down technique is widely performed in cases of long-term treatment including administration of chemotherapy, parenteral nutrition, or replacement therapies. However, it has been recommended to avoid this technique considering the resultant unpredictable alterations in the veins draining the relevant site, especially in patients who may need central venous cannulation (CVC) during disease progression. We aimed to report on CVC in a 5-year-old child who had previously undergone bilateral internal jugular venous access by the open venous cut-down technique, in order to highlight the importance of performing the Rapid Central Vein Assessment protocol prior to any intervention and considering to abandon the use of the open surgical venous cut-down technique by gaining experience with ultrasound-guided percutaneous techniques.

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Reducing peripherally inserted central catheters and midline catheters by training nurses in ultrasound-guided peripheral intravenous catheter placement

BMJ Quality & Safety ◽

10.1136/bmjqs-2019-009923 ◽

2019 ◽

Vol 29 (3) ◽

pp. 245-249 ◽

Cited By ~ 6

Author(s):

Benjamin Galen ◽

Sarah Baron ◽

Sandra Young ◽

Alleyne Hall ◽

Linda Berger-Spivack ◽

...

Keyword(s):

Venous Access ◽

Catheter Placement ◽

Ultrasound Guided ◽

Intravenous Catheter ◽

Peripherally Inserted Central Catheters ◽

Portable Ultrasound ◽

Medical Unit ◽

Ultrasound Device ◽

Peripheral Intravenous Catheter ◽

Central Catheters

BackgroundTraining nurses in ultrasound-guided peripheral intravenous catheter placement might reduce the use of more invasive venous access devices (peripherally inserted central catheters (PICC) and midline catheters).MethodsWe implemented an abbreviated training in ultrasound-guided peripheral intravenous catheter placement for nurses on an inpatient medical unit and provided a portable ultrasound device for 10 months.ResultsNurses on this unit placed 99 ultrasound-guided peripheral intravenous catheters with a high level of success. During the implementation period, PICC and midline catheter placement decreased from a mean 4.8 to 2.5 per month, meeting criteria for special cause variation. In the postimplementation period, the average catheter use reverted to 4.3 per month on the intervention unit. A comparison inpatient medical unit without training or access to a portable ultrasound device experienced no significant change in PICC and midline catheter use throughout the study period (mean of 6.0 per month).ConclusionsThese results suggest that an abbreviated training in ultrasound-guided peripheral intravenous catheter placement for nurses on an inpatient medical unit is sufficient to reduce PICC and midline catheters.

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