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First-Attempt Success, Longevity, and Complication Rates of Ultrasound-Guided Peripheral Intravenous Catheters in Children

Vinograd, Alexandra M., MD, MSHP*†; Zorc, Joseph J., MD, MSCE*†; Dean, Anthony J., MD; Abbadessa, Mary Kate F., MSN, RN, CPEN*; Chen, Aaron E., MD*†

doi: 10.1097/PEC.0000000000001063
Original Articles

Objective The aim of this study was to examine the success rates, longevity, and complications of ultrasound-guided peripheral intravenous lines (USgPIVs) placed in a pediatric emergency department.

Methods The study analyzed 300 USgPIV attempts in an urban tertiary-care pediatric emergency department. Data regarding USgPIV placement were collected from a 1-page form completed by the clinician placing the USgPIV. The time and reason for USgPIV removal were extracted from the medical record for patients with USgPIVs admitted to the hospital. A Kaplan-Meier survival analysis was performed.

Results This study demonstrated a success rate of 68% and 87% for the first and second attempts with USgPIV. Fifty-five percent of patients had 1 or more prior traditional intravenous access attempt. Most USgPIVs placed on patients admitted to the hospital were removed because they were no longer needed (101/160). We calculated a Kaplan-Meier median survival of 143 hours (6 days; interquartile range, 68–246 hours). The failure rate at 48 hours was 25%.

Conclusion Ultrasound-guided intravenous access is a feasible alternative to traditional peripheral intravenous access in the pediatric emergency setting. We observed a high first-stick success rate even in patients who had failed traditional peripheral intravenous access attempts, few complications, and a long intravenous survival time.

From the *Division of Emergency Medicine, The Children's Hospital of Philadelphia;

Department of Pediatrics, Perelman School of Medicine, and

Division of Emergency Ultrasonography, Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.

Disclosure: The authors declare no conflict of interest.

Reprints: Alexandra M. Vinograd, MD, MSPH, Division of Emergency Medicine, Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104 (e-mail:

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