Lady Minto Hospital Emergency Rounds

Prepared by Shane Barclay

Peripheral IV access using Ultrasound

Finding a vein can be difficult

…or easy

Studies have shown that with training:

1. Success for cannulation of peripheral IV is over 90%

2. Number of attempts to successful cannulation is less.

3. Therefore less traumatic to patients.

Why use ultrasound?

1. After 2 failed attempts at landmark cannulation.

2. Obese patients

3. IVDU

4. Pediatric patients

5. ? Trauma – may take too long.

When to use ultrasound

1. Difficult veins remain difficult veins

2. Use little pressure

3. Deeper vein, longer catheter

4. Failure to distinguish artery from vein

- compressibility, ?Doppler

- Brachial artery, nerve and vein are in close proximity – try to avoid.

5. Failure to identify nerve.

Pitfalls of ultrasound guided IV

Vascular Anatomy of the Arm

Venous Anatomy of the Arm

On the LMHER.com web page “Ultrasound Guided IV access” there is a 25 minute you tube video by Siegfried Emme that is very detailed but very good.

Recommended viewing

You tube Video

LMH Zonare Ultrasound Machine

1. Change to the linear array probe.

2. Set depth to minimum

3. Apply tourniquet.

4. Gel on probe

5. Align probe indicator to patient’s left.

6. Probe in transverse plane

Touch the Probes button

Touch the L10-5 button

Touch the Vasc Venous button

The screen should look like this.

Make sure both patient and you are comfortable

The End