Dataset Information

Ultrasound-guided versus landmark approach for peripheral intravenous access by critical care nurses: a randomised controlled study.

ABSTRACT: OBJECTIVE:Establishing a peripheral intravenous catheter (PIVC) after a long intensive care unit (ICU) stay can be a challenge for nurses, as these patients may present vascular access issues. The aim of this study was to compare an ultrasound-guided method (UGM) versus the landmark method (LM) for the placement of a PIVC in ICU patients who no longer require a central intravenous catheter (CIVC). DESIGN:Randomised, controlled, prospective, open-label, single-centre study. SETTING:Tertiary teaching hospital. PARTICIPANTS:114 awake patients hospitalised in ICU fulfilling the following criteria: (1) with a central venous catheter that was no longer required, (2) needing a PIVC to replace the central venous catheter and (3) with no apparent or palpable veins on upper limbs after tourniquet placement. INTERVENTION:Placement of a PIVC using an UGM. PRIMARY OUTCOME:Number of attempts for the establishment of a PIVC in the upper limbs. RESULTS:57 patients were respectively included in both the UGM group and LM group. Stasis oedema in the upper limbs was the main cause of poor venous access identified in 80% of patients. Both the number of attempts (2 (1-4), p=0.911) and catheter lifespan ((3 (1-3) days and 3 (2-3) days, p=0.719) were similar between the two groups. Catheters in the UGM group tended to be larger (p=0.059) and be associated with increased extravasation (p=0.094). CONCLUSION:In ICU patients who no longer require a CIVC, use of an UGM for the establishment of a PIVC is not associated with a reduction in the number of attempts compared with LM. TRIAL REGISTRATION NUMBER:NCT02285712; Results.

SUBMITTER: Bridey C

PROVIDER: S-EPMC6009499 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Ultrasound-guided versus landmark approach for peripheral intravenous access by critical care nurses: a randomised controlled study.

Bridey Céline C Thilly Nathalie N Lefevre Thomas T Maire-Richard Adeline A Morel Maxime M Levy Bruno B Girerd Nicolas N Kimmoun Antoine A

BMJ open 20180609 6

<h4>Objective</h4>Establishing a peripheral intravenous catheter (PIVC) after a long intensive care unit (ICU) stay can be a challenge for nurses, as these patients may present vascular access issues. The aim of this study was to compare an ultrasound-guided method (UGM) versus the landmark method (LM) for the placement of a PIVC in ICU patients who no longer require a central intravenous catheter (CIVC).<h4>Design</h4>Randomised, controlled, prospective, open-label, single-centre study.<h4>Sett ...[more]

PMID: 29886442

Similar Datasets

Project description:Introduction:The peripheral internal jugular (IJ), also called the "easy IJ," is an alternative to peripheral venous access reserved for patients with difficult intravenous (IV) access. The procedure involves placing a single-lumen catheter in the IJ vein under ultrasound (US) guidance. As this technique is relatively new, the details regarding the ease of the procedure, how exactly it should be performed, and the safety of the procedure are uncertain. Our primary objective was to determine the success rate for peripheral IJ placement. Secondarily, we evaluated the time needed to complete the procedure and assessed for complications. Methods:This was a prospective, single-center study of US-guided peripheral IJ placement using a 2.5-inch, 18-gauge catheter on a convenience sample of patients with at least two unsuccessful attempts at peripheral IV placement by nursing staff. Peripheral IJ lines were placed by emergency medicine (EM) attending physicians and EM residents who had completed at least five IJ central lines. All physicians who placed lines for the study watched a 15-minute lecture about peripheral IJ technique. A research assistant monitored each line to assess for complications until the patient was discharged. Results:We successfully placed a peripheral IJ in 34 of 35 enrolled patients (97.1%). The median number of attempts required for successful cannulation was one (interquartile range (IQR): 1 to 2). The median time to successful line placement was 3 minutes and 6 seconds (IQR: 59 seconds to 4 minutes and 14 seconds). Two lines failed after placement, and one of the 34 successfully placed peripheral IJ lines (2.9%) had a complication - a local hematoma. There were, however, no arterial punctures or pneumothoraces. Although only eight of 34 lines were placed using sterile attire, there were no line infections. Conclusion:Our research adds to the growing body of evidence supporting US-guided peripheral internal jugular access as a safe and convenient procedure alternative for patients who have difficult IV access.

Dataset Information

Ultrasound-guided versus landmark approach for peripheral intravenous access by critical care nurses: a randomised controlled study.

Publications

Ultrasound-guided versus landmark approach for peripheral intravenous access by critical care nurses: a randomised controlled study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets