1. Lady Minto Hospital Emergency Rounds Prepared by Shane Barclay

2. Finding a vein can be difficult

3. …or easy

4. Studies have shown that with training: 1.Success for cannulation of peripheral IV is over 90% 2.Number of attempts to successful cannulation is less. 3.Therefore less traumatic to patients. Why use ultrasound?

5. 1.After 2 failed attempts at landmark cannulation. 2.Obese patients 3.IVDU 4.Pediatric patients 5.? Trauma – may take too long. When to use ultrasound

6. 1.Difficult veins remain difficult veins 2.Use little pressure 3.Deeper vein, longer catheter 4.Failure to distinguish artery from vein - compressibility, ?Doppler - Brachial artery, nerve and vein are in close proximity – try to avoid. 5. Failure to identify nerve. Pitfalls of ultrasound guided IV

7. Vascular Anatomy of the Arm

8. Venous Anatomy of the Arm

10. On the LMHER.com web page “Ultrasound Guided IV access” there is a 25 minute you tube video by Siegfried Emme that is very detailed but very good. Recommended viewing You tube Video

11. LMH Zonare Ultrasound Machine 1.Change to the linear array probe. 2.Set depth to minimum 3.Apply tourniquet. 4.Gel on probe 5.Align probe indicator to patient’s left. 6.Probe in transverse plane

12. Touch the Probes button

13. Touch the L10-5 button

14. Touch the Vasc Venous button

15. The screen should look like this.

16. Make sure both patient and you are comfortable

18. The End