We performed a randomized pre-hospital clinical study to compare two different techniques of ultrasound-guided peripheral venous catheter (PVC) insertion and the conventional cannulation technique in the pre-hospital emergency setting, with a specific focus on the procedural success rate and the time required to introduce PVC. This pre-hospital prospective controlled randomized clinical trial allocated patients treated by emergency medical service to undergo PVC insertion fully controlled by ultrasound (ultrasound guidance of the PVC tip until it penetrates the lumen, group A), PVC insertion partially controlled by ultrasound (target vein identification only, group B) or to receive PVC without any ultrasound guidance (group C). The study outcomes were monitored until the patient was admitted to the hospital. A total of 300 adult patients were enrolled. The success of the first attempt (group A: 88%, group B: 94%, group C: 76%, p < 0.001) and overall success rate (A: 99%, B: 99%, C: 90%, p < 0.001) were significantly higher in the group A, followed by group B when compared to group C. The number of attempts was significantly lower (A: 1.18 ± 0.54, B: 1.05 ± 0.22, C: 1.22 ± 0.57, p < 0.001) and the time required for the procedure shorter (A: 75.3 ± 60.6, B: 43.5 ± 26.0, C: 82.3 ± 100.9 s, p < 0.001) in group B compared to groups A and C. Both techniques of ultrasound-guided PVC placement were associated with higher success rates than the conventional method. However, PVC insertion partially controlled by ultrasound was superior to full ultrasound guidance in terms of time and number of cannulation attempts required.

Department of Anesthesiology Perioperative Medicine and Intensive Care J E Purkinje University Masaryk Hospital Usti Nad Labem Socialni pece 3316 12A 400 11 Usti Nad Labem Czech Republic Department of Anesthesiology and Intensive Care Charles University Prague Faculty of Medicine in Hradec Kralove University Hospital Hradec Kralove Sokolská 581 500 05 Hradec Kralove Czech Republic Faculty of Health Studies J E Purkinje University Pasteurova 3544 1 400 96 Usti Nad Labem Czech Republic Department of Research and Development Charles University Prague Faculty of Medicine in Hradec Kralove University Hospital Hradec Kralove Sokolská 581 500 05 Hradec Kralove Czech Republic Department of Anesthesia Pain Management and Perioperative Medicine Dalhousie University Halifax NS B3H 4R2 Canada

Department of Anesthesiology Perioperative Medicine and Intensive Care J E Purkinje University Masaryk Hospital Usti Nad Labem Socialni pece 3316 12A 400 11 Usti Nad Labem Czech Republic Usti and Labem Region Emergency Medical Services Sociální péče 799 7a 400 11 Usti and Labem Czech Republic

Emergency Medical Service of the Central Bohemian Region Vancurova 1544 272 01 Kladno Czech Republic

Emergency Medical Service of the Central Bohemian Region Vancurova 1544 272 01 Kladno Czech Republic Department of Anesthesiology Perioperative Medicine and Intensive Care J E Purkinje University Masaryk Hospital Usti Nad Labem Socialni pece 3316 12A 400 11 Usti Nad Labem Czech Republic Department of Anesthesiology and Intensive Care Charles University Prague Faculty of Medicine in Hradec Kralove University Hospital Hradec Kralove Sokolská 581 500 05 Hradec Kralove Czech Republic Faculty of Health Studies J E Purkinje University Pasteurova 3544 1 400 96 Usti Nad Labem Czech Republic

References provided by Crossref.org