Ultrasound-Guided Peripheral Access: Success Depends on the Vein, Not the Patient

Ultrasound guidance is proving increasingly useful for intravenous access. To determine patient and vein characteristics that are associated with successful ultrasound-guided placement of a peripheral IV line, investigators prospectively studied a convenience sample of 169 adult patients with difficult IV access who underwent 236 attempts at venous access at a single urban tertiary care emergency department. Difficult IV access was defined as “more than two failed peripheral IV attempts or a history of difficult access plus the inability to visualize or palpate any veins on physical exam.”

Trained sonographers placed IV lines using a 20-gauge 48-mm catheter and measured the depth and diameter of target vessels. Successful placement was defin…