Microcast: Peripheral IV placement…..Ultrasound Guided of Course
Put down that central line kit!!
Now, sure, we were just showing you a couple days ago how to put in an ultrasound guided central line, but it’s usually not necessary. At Thomas Jefferson they did a study where they tried an US guided PIV on every patient they couldn’t get access on just before placing a central line…….and they eliminated 85% of those central lines! This is your chance to be a hero. No one can get the IV, so you swoop in with your trusty ultrasound machine and save the day.
If you want lots more info on this check out our recent lectures we posted on youtube of an USGPIV course we put on. Or if you want it in an even shorter form, then get the One Minute Ultrasound app where we demonstrate it in < 60 sec.
I promise, this is something you’re gonna love doing…..and your patients will love you as well.
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At out VA we do not have an IV angiocatheter longer than 1.25 inches. We do have the arrow arterial line catheters with the wire. Has anyone used the arrow type aline catheters to place these IVs? If so do you thread the wire into the vein?
Bill Clark, PA-
I’ve used the art line kits for PIV placement because they are longer (5 inches or so) and have the wire, which is nice. The downside is that they are somewhat awkward because the device is really long and you can kink the catheter on the skin. The solution for the latter problem is to make a small skin nick with another needle (like when doing an art line) and then advance the art line kit through that..
I use this same technique to do art lines.
Another trick you can consider is placing a peripherally inserted central line (or poor man’s PICC) using a long single lumen central line kit (usually a 14ga long catheter) into the basilic or cephalic veins.