Page 11 - Nursing Scope Number 2

ED Nurses begin using Ultrasound-Guided Peripheral IV
ED nurses possess some of the most incredible IV skills in the health care eld, but what happens when even the most seasoned, skilled and determined RNs are unable to obtain peripheral IV access on clients? Well... delays in testing and treatment, increased pain from multiple venipunctures, decreased throughput and increased equipment costs are just a few complications to clients with dif cult peripheral vasculature.
Alternatives to such clients often result in the need for more complicated, time consuming and invasive interventions. These range from external jugular vein catheterization, central venous catheter placement, intra-osseous cannulation and cut-down procedures. Recently, the ED at ECMC has seen
an increase in Ultrasound-Guided Peripheral IV (USGPIV) insertions by providers with specialized training. This involves the use of an ultrasound machine to view and track potential vessels in the extremities and guide a specialized catheter into the vein. This is similar to peripherally inserted central catheter (PICC) placement, except the tip of the catheter resides peripherally, instead of in the superior vena-cava.
Written by: Adam Leas, RN, BSN, EMT-P
This technique accomplished at the bedside does not require separate written consent and is considerably less invasive and can be performed in nearly the same amount of time that it takes for a traditional peripheral IV insertion.
This intervention has been exclusive to PAs, NPs and physicians, until now. This program was initiated and designed by our own ED nurses with collaboration from UB/MD Emergency Medicine - Ultrasound Division physician faculty. Select nurses from the ED at ECMC are to be among the rst ED RN’s in Western New York to received of cial training and credentialing in USGPIV.
The process involves approximately four hours of didactic and simulation training before progressing to closely supervised insertions on clients in the ED. After demonstrating competency several times, ED nurses will have a new skill
at their disposal. It will improve treatment time, lessen clients’ pain, decrease potential complications from invasive procedures, increase throughput, and make it just that much “cooler” to be an ECMC ED nurse!
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