title: Ultrasound evaluation of saphenous vein for peripheral intravenous cannulation in adults.
abstract: OBJECTIVE
  The objective of this study was to investigate variables that may affect sonographic cannulation of great saphenous vein and determine the ideal location for ultrasound-guided saphenous vein cannulation in adult emergency department (ED) patients.
  
  
  METHODS
  A prospective observational study at an academic ED. The great saphenous vein was identified in adult subjects at three distinct sites after placing the tourniquet proximal to the vein: the ankle, mid-calf, and below the knee using a 10-5 MHz linear transducer. The depth of the saphenous vein from the skin surface and its diameter were measured in supine and reverse trendelenburg positions in both extremities.
  
  
  RESULTS
  A total of 60 subjects (male 30, female 30) were enrolled in the study. The median age of the patients was 50.5 years [interquartile range (IQR) 34.5-67.5]. The median body mass index (BMI) was 27.3 (IQR, 24.2-31.8). The great saphenous vein was significantly superficial in location at the ankle level compared with the calf (p&lt;0.001), knee (p&lt;0.001), and left side compared with the right (p&lt;0.001). The subject position was not significantly related to saphenous vein depth (p = 0.68). The saphenous vein diameter was significantly larger in the left lower extremity than the right side (p = 0.007), and at the ankle level compared with the calf (p&lt;0.001) and knee (p&lt;0.001). The diameter of the vein increased significantly when patient's position changed from supine to reverse Trendelenburg (p&lt;0.001).
  
  
  CONCLUSIONS
  Our results support ultrasound evaluation of the course of great saphenous vein from the ankle to the knee for the selection of appropriate venipuncture site and cannulation.
authors.affiliation: 1 Department of Emergency Medicine, Flagstaff Medical Center, Flagstaff, AZ - USA.
authors.forename: Travis
authors.initials: T
authors.lastname: Jones
authors.forename: Nicholas
authors.initials: N
authors.lastname: Stea
authors.forename: Uwe
authors.initials: U
authors.lastname: Stolz
authors.forename: Srikar
authors.initials: S
authors.lastname: Adhikari
mesh_terms: D000328:Adult; D000368:Aged; D059925:Anatomic Landmarks; D002406:Catheterization, Peripheral; D004636:Emergency Service, Hospital; D005260:Female; D018475:Head-Down Tilt; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011677:Punctures; D012501:Saphenous Vein / Q000000981:diagnostic imaging*; D016683:Supine Position; D018084:Ultrasonography, Interventional