Stein 2009.
| Study characteristics | ||
| Methods | Randomised, open‐label trial | |
| Participants | Setting: ED Number of participants: 59 (USG 28, LM 31) Age, mean (SD) years: USG 58.1 (15.6), LM 54.8 (17.8) Difficulty: difficult (at least 2 failed attempts with LM) Sites of peripheral veins: upper extremity and jugular vein | |
| Interventions |
Technique
LM vs USG:
Machine: Sonosite Titan (Sonosite) with a 10 MHz probe
Axis: not specified
Guidance: dynamic Operator Profession: emergency physician (attending: USG and LM, resident: LM) Number of operators: 20 Experience of USG before the study: yes Length of experience with USG before the study: more than 6 months A training programme of USG for the study: yes Number of clinical cases with USG required or experienced before the study intervention started: not specified Needle Length: not specified Gauge: not specified |
|
| Outcomes | First‐pass success of cannulation, overall success of cannulation, procedure time for overall cannulation, number of attempts, patient satisfaction, complications Definition of successful cannulation: blood return from a catheter, smooth normal saline flush, and no signs of extravasation Definition of start and end of time measurement:
|
|
| Funding | None | |
| Declarations of interest | None declared | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Randomised by a research computer |
| Allocation concealment (selection bias) | Low risk | Research staff randomised participants with a research computer |
| Blinding (performance bias and detection bias) First‐pass success of cannulation | Low risk | Although blinding of participants and operators is impossible due to the nature of the intervention, a third‐person assessed the outcome |
| Blinding (performance bias and detection bias) Overall‐success of cannulation | Low risk | Although blinding of participants and operators is impossible due to the nature of the intervention, a third‐person assessed the outcome |
| Blinding (performance bias and detection bias) Procedure time for overall cannulation | Low risk | Although blinding of participants and operators is impossible due to the nature of the intervention, a third‐person assessed the outcome |
| Blinding (performance bias and detection bias) Number of attempts | Low risk | Although blinding of participants and operators is impossible due to the nature of the intervention, a third‐person assessed the outcome |
| Blinding (performance bias and detection bias) Patient satisfaction | High risk | Blinding of participants and operators is impossible due to the nature of the intervention |
| Blinding (performance bias and detection bias) Overall complications | Low risk | Although blinding of participants and operators is impossible due to the nature of the intervention, a third‐person assessed the outcome |
| Incomplete outcome data (attrition bias) First‐pass success of cannulation | Low risk | The outcome was available for all participants |
| Incomplete outcome data (attrition bias) Overall success of cannulation | Low risk | There were only 2 dropouts (USG 1, LM 1), and the reasons were detailed |
| Incomplete outcome data (attrition bias) Procedure time for overall cannulation | High risk | It seems likely that only participants with successful cannulation were analysed |
| Incomplete outcome data (attrition bias) Number of attempts | Low risk | There were only 2 dropouts (USG 1, LM 1), and the reasons were detailed |
| Incomplete outcome data (attrition bias) Patient satisfaction | High risk | There were 7 dropouts (USG 4, LM 3), and the reasons were not specified |
| Incomplete outcome data (attrition bias) Overall complications | Low risk | There were only 2 dropouts (USG 1, LM 1), and the reasons were detailed |
| Selective reporting (reporting bias) | Low risk | The outcomes reported in the article were consistent with the trial registry (NCT00692549) |
| Other bias | Low risk | No concerns about other sources of bias |
| Overall risk First‐pass success of cannulation | Low risk | All domains were at low risk |
| Overall risk Overall success of cannulation | Low risk | All domains were at low risk |
| Overall risk Procedure time for overall cannulation | High risk | At least one domain was at high risk |
| Overall risk Number of attempts | Low risk | All domains were at low risk |
| Overall risk Patient satisfaction | High risk | At least one domain was at high risk |
| Overall risk Overall complications | Low risk | All domains were at low risk |