Single v Dual-Operator Ultrasound Technique for Peripheral Vascular Access in the Emergency Department
试验速览
- 阶段
- 不适用
- 入组人数
- 128
- 主要终点
- First Pass Success
研究概览
简要总结
This is a randomized controlled trial comparing the success of US guided peripheral IV placement between single vs dual-operator technique among a convenience sample of patients with moderate or difficult vascular access in a tertiary care Emergency Department.
详细描述
Gaining intravenous (IV) access is a common and important procedure in the emergency department (ED). IV access is needed to deliver drugs, enable fluid resuscitation and sample blood, and delays in gaining access can lead to patient harm. Ultrasound (US) is a commonly used tool in the ED, and the utility of ultrasound in the placement of IVs in patients with difficult access has been well described. This study aims to further guide the use of this evidence based tool by ED Registered Nurses. The focus will be comparing single-operator technique, in which the same provider manipulates the ultrasound probe while simultaneously placing the IV, to a dual-operator technique whereby a second provider manipulates the probe. Any measured advantage has implications in guiding education and practice, as well as informing future ED policy.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult (18 years and older) patients predicted to require intravenous cannulas and identified at triage as having moderate or difficult access based on the following criteria:
- •Moderate: peripheral vein is visible or palpable but difficulty is expected based on patient characteristics both clinical and historical.
- •Difficult: No peripheral veins visible or palpable, or two failed attempts by traditional landmarking (LM).
排除标准
- •Exclusion criteria will include patients who have already undergone successful pre-hospital IV placement, patients with an indwelling vascular device, patients who are critically ill (Canadian Triage Acuity Score I) or objection to study enrolment by the attending MD for any reason. If no suitable target vein can be identified with US the patient data will be collected and the patient will be excluded from the statistical analysis.
研究组 & 干预措施
Single-Operator
For the 'Single Operator Ultrasound Guided IV placement' arm the RN operator will use the ultrasound probe to identify the target vein, and continue to hold and adjust the probe while placing the IV.
干预措施: Single Operator Ultrasound Guided IV placement (Procedure)
Dual-Operator
For the 'Dual Operator Ultrasound Guided IV placement' arm the RN operator will use the US to identify the target vein, at which time the study coordinator will hold the ultrasound probe in position. The RN operator will then place the IV.
干预措施: Dual Operator Ultrasound Guided IV placement (Procedure)
结局指标
主要结局
First Pass Success
时间窗: Total procedure time (<15 minutes)
The proportion of patients in whom vascular access is obtained on the first attempt with a single skin puncture.
次要结局
- Overall Success(Total procedure time (<15 minutes))
- Number of Attempts(Total procedure time (<15 minutes))
- Time to Canulation(Total procedure time (<15 minutes))
- Patient Pain Score(Total procedure time (<15 minutes))
- Operator Ease of Use Score(Total procedure time (<15 minutes))
研究者
Dr. Jordan Chenkin
Dr.
Sunnybrook Health Sciences Centre