Single-operator Ultrasound-guided IV Placement by Emergency Nurses

NCT01439113 | Completed

• 1 other identifier: usivedrn
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 2

Brief Summary

The placement of peripheral intravenous lines (IVs) is central to the treatment of patients in the emergency department (ED). The procedure is used for phlebotomy and administration of a variety of therapeutic medications and intravenous fluids. This procedure is standard of care, and IVs are routinely placed by experienced emergency nurses. Occasionally, the nurse will have difficulty placing an IV line. The most common reason for this is an underlying medical condition, such as diabetes, severe peripheral vascular disease, obesity, or a history of intravenous drug use. When a nurse is unable to place an IV, the options are:

1. 1.Ask another nurse to attempt the line placement
2. 2.Ask a physician to establish access, which usually involves placement of a central venous catheter, a time-consuming procedure with higher risk of infection than a peripheral line.

Conditions

Intravenous Infusions

Keywords

Ultrasound, Difficult access

Outcome Measures

Primary Outcomes (1)

• Need for intervention by a physician to obtain IV access

  The number of times a physician needs to intervene to place an IV when the nurse confronts a patient with difficult IV access

  1 year

Secondary Outcomes (3)

• Time to IV placement

  1 year

• Patient pain perception

  1 year

• Number of skin punctures required to obtain IV access

  1 year

Study Arms (2)

Standard of care

NO INTERVENTION

In this arm, patients who have difficult IV access will undergo the standard of care. The options include a) repeated attempts by a primary nurse, b) new attempts by a second nurse, c) central line placement by a physician, d) intraosseous line placement by a physician, e) physician use of ultrasound for peripheral IV placement

Ultrasound-guided IV

EXPERIMENTAL

In this arm, the emergency nurse will apply the ultrasound machine to locate and cannulate a patient's peripheral veins

Procedure: Ultrasound guided IV placement

Interventions

Ultrasound guided IV placement PROCEDURE

The nurse will use the emergency department's ultrasound machine to locate peripheral veins and then cannulate the vessel under ultrasound guidance.

Ultrasound-guided IV

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Any patient in whom IV access is indicated but either a) have a history of difficult IV access (either by self-report or by knowledge of the nurse or physician) or in whom two unsuccessful attempts (defined as skin punctures) have failed.

You may not qualify if:

• Patients will be excluded who are intoxicated, have acute psychiatric illness with exacerbation, who are prisoners, who cannot provide consent for themselves and who do not speak English.

Sponsors & Collaborators

• Tufts Medical Center: lead
• Baystate Medical Center: collaborator

Study Sites (2)

Tufts Medical Center

Boston, Massachusetts, 02111, United States

Location

Baystate Medical Center

Springfield, Massachusetts, United States

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 21, 2011
• First Posted: September 22, 2011
• Study Start: June 1, 2010
• Primary Completion: June 1, 2011
• Study Completion: June 1, 2011
• Last Updated: March 28, 2023

Record last verified: 2023-03

Locations

US (2)