Do echo-enhanced needles improve time to cannulate in a model of short-axis ultrasound-guided vascular access for a group of mostly inexperienced ultrasound users?
BACKGROUND
Vascular access is a critical skill for emergency physicians. However, it can be unpredictably challenging in some patients. While ultrasound-guided vascular access has been encouraged in emergency departments, there have been few studies evaluating echo-enhanced needles and their usefulness in performing vascular access.


OBJECTIVE
Our purpose was to determine if the use of an echo-enhanced needle tip results in faster vascular access times, with fewer needle sticks, fewer redirections, and improved needle visualization in ultrasound-guided vascular access with the vessel in the short axis.


METHODS
This is a prospective, randomized, observational study of ultrasound-guided vascular access on a vascular phantom comparing an echo-enhanced needle with a standard needle. Each participant viewed a teaching video demonstrating typical ultrasound-guided vascular access and then attempted ultrasound-guided vascular access using both a standard and an echo-enhanced needle with the vessel in the short axis. The numbers of needle sticks, redirections, and time to dye flash were measured.


RESULTS
The 69 participants attempted 69 short-axis ultrasound-guided vascular cannulations with no difference in time to dye flash between needle types: the median time from needle stick to flash was 17.56 s [interquartile range (IQR): 12.37-33.15] for the standard needle and 19.22 s (IQR: 10.19-31.10) for the echo-enhanced needle. There was no difference between needle types for number of needle sticks or redirects.


CONCLUSIONS
Echo-enhanced needles did not provide objective performance improvement compared to standard needles during ultrasound-guided vascular access with a vascular access model in the short axis.
Phelan
Michael P
MP
Department of Emergency Medicine, Cleveland Clinic, Cleveland, OH 44195, USA. PhelanM@ccf.org
Emerman
Chuck
C
Peacock
William F
WF
Karafa
Mathew
M
Colburn
Nora
N
Buchanan
Kelly
K