title: Peripherally inserted central catheter placement with the sonic flashlight: initial clinical trial by nurses.
abstract: OBJECTIVE
  We describe a case series constituting the first clinical trial by intravenous (IV) team nurses using the sonic flashlight (SF) for ultrasound guidance of peripherally inserted central catheter (PICC) placement.
  
  
  METHODS
  Two IV team nurses with more than 10 years of experience with placing PICCs and 3 to 6 years of experience with ultrasound attempted to place PICCs under ultrasound guidance in patients requiring long-term IV access. One of two methods of ultrasound guidance was used: conventional ultrasound (CUS; 60 patients) or a new device called the SF (44 patients). The number of needle punctures required to gain IV access was recorded for each patient.
  
  
  RESULTS
  In both methods, 87% of the cases resulted in successful venous access on the first attempt. The average number of needle sticks per patient was 1.18 for SF-guided procedures compared with 1.20 for CUS-guided procedures. No significant difference was found in the distribution of the number of attempts between the two methods. Anecdotal comments by the nurses indicated the comparative ease of use of the SF display, although the relatively small scale of the SF image compared with the CUS image was also noted.
  
  
  CONCLUSIONS
  We have shown that the SF is a safe and effective device for guidance of PICC placement in the hands of experienced IV team nurses. The advantage of placing the ultrasound image at its actual location must be balanced against the relatively small scale of the SF image.
authors.affiliation: Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Wang
authors.forename: Nikhil
authors.initials: N
authors.lastname: Amesur
authors.forename: Gaurav
authors.initials: G
authors.lastname: Shukla
authors.forename: Angela
authors.initials: A
authors.lastname: Bayless
authors.forename: David
authors.initials: D
authors.lastname: Weiser
authors.forename: Adam
authors.initials: A
authors.lastname: Scharl
authors.forename: Derek
authors.initials: D
authors.lastname: Mockel
authors.forename: Christopher
authors.initials: C
authors.lastname: Banks
authors.forename: Bernadette
authors.initials: B
authors.lastname: Mandella
authors.forename: Roberta
authors.initials: R
authors.lastname: Klatzky
authors.forename: George
authors.initials: G
authors.lastname: Stetten
mesh_terms: D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008029:Lighting / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009729:Nursing / Q000295:instrumentation*; D010865:Pilot Projects; D014463:Ultrasonography / Q000295:instrumentation*