title: Perceived Difficulty and Success Rate of Standard Versus Ultrasound-Guided Peripheral Intravenous Cannulation in a Novice Study Group: A Randomized Crossover Trial.
abstract: OBJECTIVE
  To our knowledge, no previous studies have evaluated the perceived levels of difficulty between traditional and ultrasound (US)-guided peripheral intravenous (IV) access in the novice provider. We attempt to show that, in a group of medical students who have limited peripheral IV experience, US-guided peripheral IV cannulation can be achieved more effectively and with a lesser degree of difficulty than standard peripheral IV cannulation.
  
  
  METHODS
  We performed a randomized crossover study of 61 first- and second-year medical students. After a 1-hour training session, participants were randomized to either standard cannulation on a standard peripheral IV trainer or US-guided cannulation on a standard US IV trainer.
  
  
  RESULTS
  One hundred percent (61 of 61) of the participants in the US-guided IV group successfully achieved cannulation versus 56% (34 of 61) of the participants in the standard IV group (P < .001). The average number of attempts to obtain access in the US-guided IV group was 1.31 versus 2.16 in the standard IV group (P < .001). The average difficulty score assigned to US-guided cannulation was 2.81 of 10 versus 3.90 of 10 in the standard IV group (P = .003).
  
  
  CONCLUSIONS
  Our study shows a decrease in perceived difficulty and a concomitant increased ability to cannulate a vein using US versus traditional landmark guidance techniques, even in the novice phlebotomist.
authors.affiliation: Department of Emergency Medicine, Virginia Commonwealth University, Richmond, Virginia USA. michael.vitto@vcuhealth.org.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Vitto
authors.affiliation: Department of Emergency Medicine, Virginia Commonwealth University, Richmond, Virginia USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Myers
authors.affiliation: Department of Emergency Medicine, Virginia Commonwealth University, Richmond, Virginia USA.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Vitto
authors.affiliation: Department of Emergency Medicine, Virginia Commonwealth University, Richmond, Virginia USA.
authors.forename: David P
authors.initials: DP
authors.lastname: Evans
mesh_terms: D002406:Catheterization, Peripheral / Q000706:statistics & numerical data*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D018592:Cross-Over Studies; D006801:Humans; D013337:Students, Medical / Q000706:statistics & numerical data*; D018084:Ultrasonography, Interventional / Q000706:statistics & numerical data*
keywords: medical student; ultrasound; ultrasound education; ultrasound-guided peripheral intravenous cannulation