Bedside ultrasound (US) is an extremely valuable tool to increase success rates for acquiring difficult intravenous (IV) access [1–3]. Patients for whom the landmark method is technically difficult include: obese or edematous patients, those undergoing dialysis, chemotherapy treatments, frequent IV placement for any other chronic illness, or a history of IV drug use. Safe and effective US-guided IV access has also been shown to decrease the utilization of central venous catheters in non-critical patients [4, 5], while also increasing patient satisfaction in those who are discharged from the emergency department . In pediatric patients as well, use of US may decrease the number of attempts made to attain IV access [7, 8]. This skill can be learned by physicians, nurses [9–11], and technicians  alike.
KeywordsVein Artery Antecubital fossa Basilic vein Brachial vein
Ultrasound video of antecubital fossa veins being compressed. Notice how the veins fully collapse upon application of pressure. This helps differentiate between vein and artery when attempting to obtain IV access. Video courtesy of Stephen Alerhand (MOV 6504 kb)
Ultrasound video of medial upper arm veins being compressed. Notice how the veins fully collapse upon application of pressure. This helps differentiate between vein and artery when attempting to obtain IV access. Video courtesy of Stephen Alerhand (MOV 6892 kb)
- 5.Shokoohi H, Boniface K, McCarthy M, Khedir Al-tiae T, Sattarian M, Ding R, et al. Ultrasound-guided peripheral intravenous access program is associated with a marked reduction in central venous catheter use in noncritically ill emergency department patients. Ann Emerg Med. 2013;61(2):198–203.CrossRefPubMedPubMedCentralGoogle Scholar