When searching for an appropriate vessel for peripheral IV insertion in an upper extremity using ultrasound guidance, which of the following greatest improves chances of successful cannulation? A. diameter >0.4 cm B. depth <0.3 cm C. brachial location D. echogenic contents within lumen
A. diameter >0.4 cm Explanation: choosing a compressible, anechoic vessel with a venous flow profile and a diameter >0.4 cm which lacks surrounding arteries and nerves and is located between 0.3 and 1.5 cm from the skin surface increases one's chances of successful cannulation.
Linear transducer applied to lateral aspect of right upper extremity, just proximal to antecubital fossa. Basilic vein identified in cross-section (short axis) with compression to rule out occult thrombus and mistaken selection of an artery for cannulation.
Transducer rotated 90 degrees for dynamic visualization of cannulation. Cineloop demonstrates puncture of anterior wall of lumen, with subsequent reduction of needle angle. Confirmatory long axis image then saved. Needle was advanced a further centimeter (not shown) with subsequent advancement of angiocatheter into lumen without resistance.
Needle removed and protected, distal compression was applied to vein as tourniquet was removed and IV tubing attached and secured. Revisualization of long axis catheter in lumen with subsequent confirmation of intravascular location was confirmed saline flush test (second cine-loop).