Comparison of Ultrasound-guided, Infrared Illumination, and Standard Techniques for Peripheral Venous Line Placement in Adults With Difficult Venous Access

What this Trial Is About

Peripheral venous catheterization (PVC) is a common invasive procedure important for patients needing rapid and safe vein access, especially those with difficult veins. This trial evaluates three methods to improve the success rate of PVC on the first attempt in adults with challenging venous access: the classical clinical examination method, ultrasound-guided technique, and infrared illumination technique. The study aims to identify which technique works best to reduce pain, improve satisfaction, and increase success, based on the A-DIVA clinical score used to predict difficulty with PVC. Participants are randomly assigned to one of three groups: the standard landmark technique using observation and palpation, an infrared device to visualize veins, or an ultrasound-guided method for vein visualization and catheter placement. The study takes place in a single center and involves patients scheduled for CT scans requiring PVC, with an A-DIVA score of 2 or more. Each patient is involved for up to 4 hours during which catheterization attempts and related measurements are made. During the study, researchers will assess the number of attempts needed for successful catheterization, pain levels using a 0-10 scale, patient and operator satisfaction, time from preparation to success, and fallback strategies if initial attempts fail. Catheter sizes used and the impact of the A-DIVA score on technique choice will also be recorded. The primary outcome is the proportion of successful PVCs on the first attempt, defined by painless administration of saline without edema or complications. The total study duration is approximately one year.

Comparison of the Effectiveness of Ultrasound-guided Techniques and Infrared Illumination, Compared With the Standard Approach to Peripheral Venous Line Placement in People With Difficult Venous Access