Table 3.

Outcome Measures and Ultrasonographic Approach

Study	# Patients/ Participants	Outcome Measure	First Stick Success (%) (USG)	Overall Success (%)	# Punctures	US Approach
Acuña, et al 202019	483	• Success rate of USGPIVA placement • Complications associated with USGPIVA • Adequacy of handheld device for USGPIVA placement • Confidence level in performing USGPIVA with handheld device	84% First Attempt Success	92% Overall Success	N/A	In-plane 70% Out-of-plane 10% Not documented 20%
Ault, et al 201523	8 Nurses (Patients Not Recorded)	• Number of USGPIVA placements that needed to be performed under supervision to achieve proficiency and consistency • Number of minutes required for successful vessel cannulation • Associated complications	N/A	N/A	N/A	N/A
Bahl, et al 201620	124	• USGPIVA success rate • Time to USGPIVA placement	N/A	76% Overall Success	Mean USGPIVA: 1.52 per subject SOC: 1.71 per subject	N/A
Duran-Gehring, et al 201624	830	• First attempt success USGPIVA • Overall PIV success • Number of blind punctures prior to USGPIVA	97.5% Overall Success	86.8% First Attempt Success	Mean SOC: 2.1 per subject USGPIC: N/A	Veins were examined in both transverse/long-axis planes to determine depth and width Single operator, transverse, out-of-plane approach for cannulation Rotate to long-axis to confirm position of catheter within lumen of the vessel
McCarthy, et al 201625	1,617	• Success/failure on initial/second attempt • Occurrence of a complication • Patient reported pain associated with the procedure (0-10) • Duration of first attempt	82%-86% Regardless of Difficulty	80.9% Overall Success	N/A	Dynamic, single operator technique US utilized to visualize and guide the needle into the lumen
Oliveira, et al 201626	65	• Success of physicians, nurses, and corpsmen utilizing USGPIVA • Number of attempts	Nurses: 63.2% Corpsmen: 50% Participants all novice with <5 USGPIVA procedures performed before study commencement	N/A	Average 2.8 per patient	Single operator, dynamic technique Participants encouraged to utilize transverse/longitudinal techniques A novel combination approach taught, involved participants inserting needle in transverse position then rotating probe longitudinally visualize the catheter in the vessel
Price, et al 201922	100	• First attempt success rate between double tourniquet and single tourniquet groups (USGPIVA)	Single Tourniquet –79.2% Double Tourniquet – 76.5%	Single Tourniquet – 97.9% Double Tourniquet – 98%	Average 1 per patient (USGPIVA)	Participants measured vessels in short-axis orientation Approach to achieve cannulation was not reported
Resnick, et al 200827	101	• Success of skin marking procedure (USGPIVA) • Procedural time • Perceived reason for blind failure • Target vein selection • Depth of target vein • Number of skin punctures • Length of catheter in the vein • Associated complications	59.6% First Attempt Success (Varying Experience)	73% Second Attempt	N/A	Target vessel identified; depth measured in short-axis Catheters were inserted using a dynamic, single operator technique All operators began the procedure in short-axis view and allowed to change to long-axis view if struggling to gain access
Salleras-Duran, et al 20164	103	• Nurse perception of difficulty • Success rate USGPIVA overall/first attempt • Catheter longevity • Patient satisfaction	84.2% First Attempt Success	95.1% Overall Success	N/A	N/A
Schoenfeld, et al 201128	219	• Success rate of USGPIVA • Complication rate • Rate of success based on previous ED technician experience with both standard approach and USGPIVA	78.5% First Attempt Success	Not Reported	Mean 1.35 (SD = 0.56)	Dynamic, single operator technique Both transverse/longitudinal methods were taught Participants encouraged to begin with transverse method
Shokoohi, et al 20139	401,532	• Central venous catheter placement rate	N/A	N/A	N/A	N/A
Skulec, et al 20205	300	• Compare first attempt success between three groups of varying approach • Compare overall success of cannulation • Number of attempts for successful cannulation • Time required to achieve cannulation • Prehospital complications	Fully USG technique where needle visualized to penetrate lumen (Group A) – 88% Partial USG technique visualizing target vessel only (Group B) – 94% Landmark approach (Group C) – 76%	Group A – 99% Group B – 99% Group C – 90%	Group A: 1.20 (SD = 0.57) Group B: 1.07 (SD = 0.29) Group C: 1.45 (SD = 0.90) P <.001	Scanning with transverse probe orientation to identify target vein Compression test to differentiate between vein and artery Color doppler was used optionally by the operator Participants instructed to preferentially use transverse approach
Stolz, et al 201618	796	• Number of attempts required to achieve proficiency and consistency • Overall success rate • Determinants of difficulty	N/A	88.24% Overall Success	N/A	In-plane, longitudinal approach where needle was guided into the vessel was emphasized for PIV access Participants familiarized with color doppler, compression technique, and transverse method
Vinograd, et al 201829	58 (300 USGPIVA Attempts)	• First attempt success • Complication rates • USPGIV longevity	68% First Attempt Success	91% Overall Success	N/A	All PIVs were placed using the dynamic method in the short-axis
Weiner, et al 201310	50	• Rate of physician intervention • Mean time to PIV placement • Number of skin punctures • Patient satisfaction • Patient perception of pain on 10-point scale	N/A	N/A	Mean: 2	Dynamic, single operator technique Nurses were instructed to use the transverse approach at 45° oblique angle to the vessel
Miles. et al 201221	9 Initial Participants	• Rate of physician intervention • Time to PIV placement • Number of skin punctures • Patient satisfaction • Patient perception of pain	N/A	N/A	N/A	Nurses were taught both transverse/longitudinal approaches Participants typically preferred transverse method until more experienced

Abbreviations: US, ultrasound; USG, ultrasound-guided; USGPIVA, ultrasound-guided peripheral intravenous access; PIV, peripheral IV; ED, emergency department; SOC, standard of care.