Perceived Difficulty and Success Rate of Standard Versus Ultrasound-Guided Peripheral Intravenous Cannulation in a Novice Study Group: A Randomized Crossover Trial

OBJECTIVES: 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.