title: First-Attempt Success, Longevity, and Complication Rates of Ultrasound-Guided Peripheral Intravenous Catheters in Children.
abstract: OBJECTIVE
  The aim of this study was to examine the success rates, longevity, and complications of ultrasound-guided peripheral intravenous lines (USgPIVs) placed in a pediatric emergency department.
  
  
  METHODS
  The study analyzed 300 USgPIV attempts in an urban tertiary-care pediatric emergency department. Data regarding USgPIV placement were collected from a 1-page form completed by the clinician placing the USgPIV. The time and reason for USgPIV removal were extracted from the medical record for patients with USgPIVs admitted to the hospital. A Kaplan-Meier survival analysis was performed.
  
  
  RESULTS
  This study demonstrated a success rate of 68% and 87% for the first and second attempts with USgPIV. Fifty-five percent of patients had 1 or more prior traditional intravenous access attempt. Most USgPIVs placed on patients admitted to the hospital were removed because they were no longer needed (101/160). We calculated a Kaplan-Meier median survival of 143 hours (6 days; interquartile range, 68-246 hours). The failure rate at 48 hours was 25%.
  
  
  CONCLUSIONS
  Ultrasound-guided intravenous access is a feasible alternative to traditional peripheral intravenous access in the pediatric emergency setting. We observed a high first-stick success rate even in patients who had failed traditional peripheral intravenous access attempts, few complications, and a long intravenous survival time.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Vinograd
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Zorc
authors.affiliation: Division of Emergency Ultrasonography, Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Dean
authors.forename: Mary Kate F
authors.initials: MKF
authors.lastname: Abbadessa
authors.forename: Aaron E
authors.initials: AE
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008136:Longevity; D008297:Male; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000379:methods*