Establishment of a Peripheral Intravenous Catheter with the Ultrasound-Guided Method by Critical Care Nurses

Abstract

The placement of ultrasound-guided peripheral intravenous catheters by nurses is an innovative technique that is being developed in intensive care units where senior physicians are 24 hours a day on call. This technique makes easier the placement of peripheral intravenous catheters in patients with edema or poor superficial venous network. Thus, ultrasound detection of the venous network in these patients could avoid the placement of a central catheter. Skills’ training of this technique by nurses requires theoretical and practical learning. Although similar in many aspects to the landmark method, ultrasound-guided method requires a specific but easy to acquire training. For instance, the puncture is performed with only one hand, and the operator is focused not only on the patient’s arm but also on the ultrasound scan screen. Consequently, patient and operator positions but also echograph setups should be optimized before puncture in order to minimize the risk of failure. Finally, if the acquisition of this new procedure by nurse requires a specific training, it is also a motivating source for the paramedic team.