Nurse-led Placement of Peripheral Venous Catheters in Overweight Patients Using Standard or Dynamic Ultrasound-guided Technique (DUST)

University Hospital, Linkoeping

Status: Completed

Conditions: Emergencies; Overweight and Obesity

Treatments: Device: Dynamic ultrasound-guided short-axis needle tip navigation; Other: Standard technique of placing a PVC

Study type: Interventional

Funder types: Other

Identifiers

NCT04412967

SE-2020 JG DUST

Details and patient eligibility

About

Overweight and obesity may be associated with difficult intravenous access leading to longer procedure time and more placement attempts of peripheral venous catheters (PVC). Dynamic ultrasound-guided short-axis needle tip navigation (DUST) may facilitate the procedure.

This was a prospective, randomized, non-blinded study to compare time and placement attempts for nurse-led standard (ST) and ultrasound guided PVC placement in 90 emergency patients with a BMI ≥25kg/m2.

Consenting patients were randomized at a 1:1 ratio to receive PVC by either ST or DUST.

Application time was defined as the time from applying stasis to visible blood in the PVC flash-chamber.

No difference in time was found (medians: ST 42 s; DUST 53.5 s, P = 0.535). There were on average 17 % less placement attempts in the DUST-group (median 1 attempt; Q1 = 1 Q3 = 1) compared to the ST-group (median 1 attempt; Q1 = 1 Q3 = 1.5), (p = 0.031). Patients reported no differences in perceived pain (p = 0.955) or perceived satisfaction (p = 0.342). Pain and subcutaneous infiltrations were the only side-effects reported (ST-group 6, DUST-group 5).

DUST does not decrease time to functional PVC but reduces the number of PVC placement attempts in patients with BMI ≥25 kg/m2.

Enrollment: 89 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• REETS prioritization level of "Orange", "Yellow", "Green" or "Blue"
• 18 years old
• BMI ≥25 Kg/m2
• Need of PVC according to Emergency department guidelines
• Able to give written informed consent

Exclusion criteria

• Unable or unwilling to provide informed consent
• Life threatening patient status (REETS prioritization level of "Red")
• Immunosuppression
• Pregnant or lactating women
• Blood infections
• Puncture zone skin damaged (burns, eczema, infection)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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89 participants in 2 patient groups

Standard Technique PVC placement

Active Comparator group

Description:

Standard PVC placement technique

Treatment:

Other: Standard technique of placing a PVC

DUST

Experimental group

Description:

Dynamic ultrasound-guided short-axis needle tip navigation (DUST)

Treatment:

Device: Dynamic ultrasound-guided short-axis needle tip navigation