Ultrasound-Guided Peripheral Venous Access

Author: Martin Necas - Clinical Specialist Sonographer and Clinical Tutor of Ultrasound Imaging at Waikato Hospital in Hamilton, New Zealand

US IV access
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Ultrasound-guided peripheral venous access is a powerful clinical skill that can reduce failed cannulation attempts and save time. From a patient perspective, the technique can instil a renewed sense of gratitude and faith in our work, particularly in those with multiple past failed attempts. With good quality ultrasound becoming ubiquitous, this skill is within easy reach of all ultrasound users.


The key requirements are: an ultrasound system with a high frequency linear array transducer, existing skill in visually guided IV cannulation, a steady pair of hands and a willingness to learn. If you are reading this column, there is a high chance that you have all the ingredients already nicely aligned!


In the linked presentation (which you are welcome to have, use and share), I cover the fundamentals of ultrasound guidance and discuss the transverse and longitudinal technique. Which technique you adopt is up to you. They each have their distinct advantages and disadvantages, but in skilled hands, both will result in successful ultrasound-guided IV access.


But before you unleash your newly acquired knowledge about ultrasound-guided IV access on real patients, it is important to have a few trial runs on a phantom first and then to perform your first few cannulations under the supervision of an expert. It won’t take long before you are placing your own lines with confidence.


There is just nothing better than being able to use ultrasound to see where you are going!

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