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Ultrasound Aids IV Line Placement in Children

TUESDAY, Aug. 13, 2019 -- Ultrasound guidance improves first-attempt success in establishing intravenous lines in children, according to a study published in the July issue of the Annals of Emergency Medicine.

For the study, Alexandra M. Vinograd, M.D., from Children's Hospital of Philadelphia, and colleagues recruited 167 children requiring an intravenous line and who were predicted to have difficult intravenous access according to a previously validated score. Patients were randomly assigned to either traditional or ultrasonographically guided intravenous line placement on first attempt.

The researchers report that first attempt success was increased in the ultrasonographically guided intravenous line placement arm versus the traditional intravenous line arm (85.4 versus 45.8 percent; relative risk, 1.9; 95 percent confidence interval, 1.5 to 2.4). In the ultrasonographically guided intravenous group, there were fewer attempts (median, one versus two; median difference, 1.0; 95 percent confidence interval, 0.8 to 1.2) and a shorter time from randomization to intravenous line flush (median, 14 versus 28 minutes) compared with the traditional intravenous group. Finally, ultrasonographically guided intravenous lines survived longer than traditional intravenous lines (median, 7.3 versus 2.3 days). Complications were similar between the groups, but parents were more satisfied with ultrasonographically guided intravenous placement.

"These results may be used to update guidelines for intravenous line access in children in an effort to limit the number of needle sticks they experience," a coauthor said in a statement.

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Posted: August 2019