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Impact of Ultrasound on Short Peripheral Intravenous Catheter Placement on Vein Thrombosis Risk

Holder, Max R. BSN, RN; Stutzman, Sonja E. PhD; Olson, DaiWai M. PhD, RN

doi: 10.1097/NAN.0000000000000219
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Approximately 90% of hospitalized patients have a short peripheral intravenous catheter (SPC) placed. Methods of inserting the catheter have evolved over time and now include the use of ultrasound (US)-guided procedures for placement. Little is known about the impact that US-guided procedures have on the vein. This study compared the rate of venous thrombosis in patients with and without US-guided catheter placement. This prospective, single-blind, observational study assessed for venous thrombosis in 153 veins from 135 patients. Veins were evaluated by a research nurse blinded to the method of placement between 48 and 72 hours after the SPC was placed. The Fisher exact test showed a significant difference between vessel compressibility and catheter insertion method (P = .0012). The proportion of noncompressible veins was significantly greater when US was used in comparison with freehand SPC insertion. The Mantel-Haenszel chi-square value of 10.34 (P = .0013) showed that US insertion technique is associated with a higher likelihood of noncompressible veins. This pilot study provides compelling evidence that the use of US to assist with catheter placement is associated with a higher rate of noncompressible veins at day 2 or 3. Further studies are needed with a larger sample to determine the generalizability of the results from this pilot study.

The University of Texas Southwestern Medical Center, Dallas, Texas.

Max R. Holder, BSN, RN, is the manager of the vascular access team in the Imaging Department at the UT Southwestern Medical Center.

Sonja E. Stutzman, PhD, is the research manager for the Neuroscience Nursing Research Center at the UT Southwestern Medical Center.

DaiWai M. Olson, PhD, RN, is a staff nurse and associate professor of neurology and neurotherapeutics at the UT Southwestern Medical Center.

Corresponding Author: DaiWai M. Olson, PhD, RN, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8855 (DaiWai.Olson@UTSouthwestern.edu).

Max Holder is a clinical educator for Bard Access and is on the Board of Directors of the Infusion Nurses Society.

The other authors have no conflicts to disclose.

© Copyright 2017 by Infusion Nurses Society