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The principles of ultrasound-guided venous access in adults, with considerations for pediatric populations, are reviewed. A general overview, including central vein anatomy, types of venous devices and their selection, and techniques for central venous access at specific sites, is presented separately.
Ultrasound-guided PIV insertion is also an effective alternative to CVC insertion in patients with difficult venous access. 17)We suggest using real-time ultrasound guidance to reduce the risk of vascular, infectious, and neurological complications during PIV insertion, particularly in patients with difficult venous access.
First-time success rate for peripheral IV placement ranges from 65 to 86 percent [1]. This topic will discuss the indications, contraindications, performance, and complications of peripheral venous catheter placement without the use of ultrasound guidance.
Dynamic ultrasound guidance — Prior to needle access, the selected artery is identified using physical examination using appropriate anatomic landmarks and pulse, combined with imaging techniques such as ultrasound or fluoroscopy.
Percutaneous procedures, including both diagnostic and interventional, begin with access to an artery. Depending on the procedure planned, vessels of the upper or lower extremities, or both, are used. The artery can be accessed either in a retrograde or antegrade manner in relation to the flow.
Patients often need central venous access for indications including ongoing hemodynamic monitoring, difficult venous access, or long-term intravenous therapy (eg, antimicrobial therapy, fluid therapy, chemotherapy).
Ultrasound-guided PIV insertion is also an effective alternative to CVC insertion in patients with difficult venous access. 17)We suggest using real-time ultrasound guidance to reduce the risk of vascular, infectious, and neurological complications during PIV insertion, particularly in patients with difficult venous access.
Insertion of vascular access is a common procedure with potential for iatrogenic events, some of which can be serious. The spread of ultrasound scanners in operating rooms, intensive care units and emergency departments has made ultrasound-guided catheterisation possible.
BACKGROUND Ultrasound (US) guidance increases safety and efficacy in vascular cannulation and is considered the standard of care. However, barriers including workflow interference and the need to be assisted by a second operator limit its adoption in clinical routine.
This topic will discuss the selection of a site for vascular access as well as techniques for peripheral and central percutaneous access and venous cutdown. Intraosseous (IO) cannulation and ultrasound-guided vascular (venous) access are discussed separately.