Handheld Ultrasound: Overcoming the Challenge of Difficult Peripheral Intravenous Access in the Emergency Department

Josie Acuña, Jacob Sorenson, Anthony Gades, Ryan Wyatt, Nicholas Stea, Maili Drachman, Srikar Adhikari

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objectives: The purpose of this study was to evaluate the performance of a handheld ultrasound device for difficult peripheral intravenous (PIV) access performed by nurses and paramedics in the emergency department (ED). Methods: This was a retrospective review at an academic medical center. Participants were ED nurses and paramedics with competence in ultrasound-guided PIV placement. Participants were asked to log their use of the handheld device when used on patients deemed to have “difficult” access and complete a questionnaire, which consisted of items related to the effectiveness and ease of use of the device. Data were collected over the course of 1 year. An electronic medical record review was performed to track the success rates and the occurrence of any associated complications throughout the hospital stay. Results: Nurses and paramedics logged a total of 483 cases in which PIV access was attempted with the handheld ultrasound device. Ninety-two percent (95% confidence interval [CI], 89%–94%) of the ultrasound-guided PIV lines attempted were placed successfully. Eighty-four percent (95% CI, 80%–87%) of the lines were placed successfully on the first attempt. In most cases (396 of 483 [82%]), no complications associated with the PIV occurred. A total of 429 questionnaires were completed over the study period. Most of the operators (84%; 95% CI, 80%–87%) stated that the handheld device was adequate to perform ultrasound-guided PIV access. Conclusions: The handheld ultrasound device performed well in terms of usability and reliability for PIV access.

Original languageEnglish (US)
Pages (from-to)1985-1991
Number of pages7
JournalJournal of Ultrasound in Medicine
Issue number10
StatePublished - Oct 1 2020


  • catheterization
  • emergency medicine
  • intravenous access
  • nursing
  • ultrasound

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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