Background: Peripheral intravenous access is a common medical procedure, however, it can be difficult to perform in some patients. Success rates have proved greater with ultrasound guidance. Peripheral intravenous access using ultrasound requires specific training, especially for new ultrasound users. To overcome these difficulties, guidance devices on ultrasound probes are able to control the angle of penetration into tissues. We hypothesized that, and particularly for new ultrasound users, the use of a needle guide (NG) paired with the out-of-plane approach would facilitate puncture of a simulation model of vessel more effectively than similar free hand (FH) techniques. Methods: A prospective controlled randomized study was conducted of new ultrasound users using a guide wire introducer needle on gelatine phantom. After a 30-min lecture, one group performed the FH technique and the other group performed the NG technique both in an out-of-plane approach. The main criterion was the number of attempts before success of catheterization of this model of vessel. Results: Thirty-four nurse anesthetist students participated in the study. The number of attempts before success using the NG technique was significantly lower: 3.7 (±0.9) in the NG group versus 6.7 (±3.3) in the FH group ( p = 0.01). In the NG group, 100% of the participants achieved success after the sixth attempt. In the FH group, only 81.25% ( n = 13/16) reached success. Conclusion: NG technique has been proved to have a steeper learning curve compared with the FH technique. A study on a learning curve in clinical practice is needed to confirm these results.
Continuous infusion versus intermittent flushing: maintaining peripheral intravenous access in newborn infants
