Learning Objective 1: discuss complications associated with ultrasound-guided intravenous access
Learning Objective 2: describe an intravenous alternative for patients with difficult intravenous access.
Methods: A randomized controlled trial of 105 subjects presenting for outpatient procedures who had failed IV access was conducted. Subjects were referred to the infusion specialist for IV insertion. Subjects were randomly assigned to either the USMST treatment (n=53) or USG control (n=52) arm. Experienced infusion specialist nurses performed both procedures. Complications and patient satisfaction were assessed 72 hours after the procedure. Endpoints were IV access success rate, time from first percutaneous attempt to successful cannulation, number of percutaneous attempts, complications (e.g., hematoma, phlebitis), and patient satisfaction. Data were analyzed with chi-square and independent t-test statistics.
Results: No significant differences were noted in group characteristics. The majority of subjects were female (58%) admitted for cardiac catheterization (60%); and average age 61 years. Subjects in the USMST group had a higher success rate (100% versus 90%; p=.021), fewer attempts (1 versus 2; p<.001), shorter insertion time (2 minutes versus 10 minutes; p<.001), and fewer complications (9% versus 44%; p=.001). Hematoma was the most frequent complication observed. Subject satisfaction was higher in the USMST group (9.7 on 10-point scale versus 5.7; p<.001).
Conclusion: Subjects in the treatment group were more satisfied, had fewer complications, less attempts and the procedure took less time. IV insertion using USMST is a safe and quick method for infusion specialist nurses to use for patients with difficult IV access.
See more of: Research Sessions – Oral Paper & Posters