Ultrasound for Peripheral IV's - page 2

by RNCENCCRNNREMTP

Is anybody using an ultrasound machine (like the Sonosite) for finding/starting peripheral IV's. I did my first one the other night, deep brachial in a man who had bilateral forearm trauma and marked edema from overzealous... Read More


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    I have been using the ultrasound to place PIV for about 6 years now. I starting when I was evaluating ultrasound that were going to be used for PICC placement which I had not gone to the training program yet, so I needed some way to get an idea of use. So I started on patients that I could have techniquely obtained without the ultrasound. that way I could see the relationship between the ultrasound and the vein. Now I work for solely for a PICC team and have been training the nurses in certain areas to use this tool with strict policy and guidelines. I Have taught some staff nurses in a level one trauma to use their ultrasound for this since we do not have an IV team at this hospital. The clinical coordinator of the Trauma and myself have designed a policy and procedure explaining the ins and out. For these PIV we are using a longer needle sometime because these veins are deeper in orientation with the ultrasound. One needs to be mindful of how much catheter will sit within the vein, this is crucial to the life of the catheter. Currently we are tracking these PIV to see the life of them and to monitor for complications. I think this procedure is ideal for procedural areas and need more caution with in patient settings.
  2. 0
    Also be aware that recent studies show about a 50 percent failure rate of US guided PIVs within 24 hrs. I have found this to be true in my practice setting as well. These lines need to be considered a "bridge" line to a more appopriate access forthe patient that usually has very limited suitable veins for peripheral therapy.
  3. 0
    Hello Madam PICC and Iluvivt,
    We are looking at developing a policy in our institution at this time for Ultrasound guided PIV's. Would it be possible to have you send me(or direct me to) your policies for this procedure? We are venturing out and want to start it off on the right foot.

    Thank you
    Warren
  4. 0
    At the 2009 AVA conference there was a presentation on this with suggestions for current guidelines....I outlined in a PM..let me see if I can find that and send it..ironically our policies matched . I know ours came from the "school of hard knocks"
  5. 0
    we have had similar needs with difficult access patients. in the past we would place piccs in anyone needing access or a power injection procedure. starting over a year and a half ago, i began researching and identifying products and techniques that would be helpful in meeting our needs. i have now developed a procedure to place deep vein pivs that are safe, can be power injected and used for 7-10 days.

    i would love to go into detail, but i am a believer of evidence-based practice. my physicians have approved the procedure step by step and now i am going to collect the data from chart reviews. i have placed over 200 "deep vein piv' so the numbers should have some weight. it will take time, but patient safety is more important.

  6. 0
    Madam PICC and iluvivt,

    I am working on a sonosite iv learning module for my ED, would either you be able to send me copies of your institutions policy/procedure for us placed peripheral ivs? Only a few MDs in my ED and even fewer RNs have been using this technique. We currently have the sonosite Mturbo.

    Any information is greatly appreciated.

    Thanks!
  7. 0
    I have been doing this for years now as an ER and Sicu nurse coordinator, and nurse manager in a large level 1 trauma center and we have the titan but only the IV team, ER, and ICU nurse coordinators and charge nurses are trained to do it. It is a very advanced procedure and not every nurse should be do it on a routine basis.
  8. 0
    My facility is also trying to incorporate a policy and procedures for ultrasound IV, my director has left it up to me to get the ball rolling. Any info would be greatly appreciated. My email is LarsenTrevor@gmail.com if you have any thing to send me in right direction! thanks
  9. 0
    Is there a special needle to order the 1 and 3/4 needle and 2.5 inch needle. Or can we use the extra needle found in the Bard PICC Kit?


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