Effectiveness of Ultrasound in Pediatric peripheral vascular access- A nursing perspective

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  • 1. A PROSPECTIVE RANDOMIZED STUDY TO ASSESS EFFECTIVENESS OF ULTRASOUND FOR PERIPHERAL VASCULAR ACCESS IN PEDIATRIC PATIENTS Presented by ;Mary Teenu Guide: Dr. Deepak Agrawal
  • 2. Problem statement A prospective randomized study to assess effectiveness of ultrasound for peripheral vascular access in pediatric patients.
  • 3. Introduction • Vascular access in pediatric patients is often more difficult than adults because of the smaller size of the vessels and non-cooperation. Ultrasound is an invaluable tool for vascular access by nurses in this population
  • 4. Objectives • To compare overall success rate of iv insertion in ultrasound and non ultrasound group • To compare first IV line insertion success rate of ultrasound and non ultrasound group • To compare average number of attempts made in ultrasound and non ultrasound group
  • 5. Objectives • To compare average needle redirections in ultrasound and non ultrasound group • To compare IV line average insertion time of ultrasound and non ultrasound group
  • 6. METHODOLOGY
  • 7. Study design • Prospective randomized study
  • 8. Population • Pediatric patients who require peripheral IV line
  • 9. Site • All India Institute of Medical Sciences, New Delhi
  • 10. Setting • Neurosurgery ICU, JPNATC, AIIMS
  • 11. Sampling technique • Simple random sampling
  • 12. Inclusion criteria • Age <10 years • Patients who require peripheral vascular access
  • 13. Study period • 2 months (1st June- 31st July 2013)
  • 14. Procedure • Subjects were selected and assigned randomly to group A and group B. – Group A subjects were cannulised with the use of ultrasound – Group B were cannulised without any aid. First insertion success rate, access time and complications were compared between the two groups
  • 15. Ultra sound view of vein
  • 16. RESULTS
  • 17. TOTAL SUBJECTS : 14 GROUP B: 7GROUP A: 7 Subject Distribution
  • 18. Demographic data Mean age (range) Group A 6years (5 months to 8years) Group B 5.2 years (9 months to 10 years) N =14
  • 19. Demographic data… Male Female Group A (n=7) 4 (57.14%) 3 (42.85%) Group B (n=7) 5 (71.42%) 2 (28.57%) N =14
  • 20. Overall success rate Group A (n=7) 6 (85.71%) Group B (n=7) 4 (57.14%) N =14
  • 21. First IV line insertion success rate Group A (n=7) 6 (85.71%) Group B (n=7) 3 (42.85%) N =14
  • 22. Average number of attempts made Group A (n=7) 1.4 Group B (n=7) 4 N =14
  • 23. Average needle redirections Group A (n=7) 2.4 Group B (n=7) 5 N =14
  • 24. Average time taken for the procedure (Range) Group A (n=7) 2.6 min (2- 5 min) Group B (n=7) 3.3 min (2.5 - 6 min) N =14
  • 25. Conclusion • In a sample of pediatric patients ultrasound-guided intravenous cannulation required less overall time, fewer attempts, and fewer needle redirections than traditional approaches. Overall success rate and first insertion success rate is more in ultrasound guided method.