Health System Impact of Emergency Department-based Vascular Access Program in Patients with Difficult Intravenous Access

Background: Ultrasound guided (USG) peripheral intravenous (PIV) access is a vital use of point of care ultrasound (POCUS) that decreases time to access, reduces need for more invasive access, preserves vasculature, and improves patient experience. Objectives: We describe the impact of an Emergency...

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Main Authors: Nathan P Roll, Shilpa Raju, Micah Ownbey, Jamal Jones, Christy Hopkins, Jennifer Cotton
Format: Article
Language:English
Published: CINQUILL Medical Publishers Inc. 2025-04-01
Series:POCUS Journal
Subjects:
Online Access:https://ojs.library.queensu.ca/index.php/pocus/article/view/18274
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author Nathan P Roll
Shilpa Raju
Micah Ownbey
Jamal Jones
Christy Hopkins
Jennifer Cotton
author_facet Nathan P Roll
Shilpa Raju
Micah Ownbey
Jamal Jones
Christy Hopkins
Jennifer Cotton
author_sort Nathan P Roll
collection DOAJ
description Background: Ultrasound guided (USG) peripheral intravenous (PIV) access is a vital use of point of care ultrasound (POCUS) that decreases time to access, reduces need for more invasive access, preserves vasculature, and improves patient experience. Objectives: We describe the impact of an Emergency Department (ED) based vascular access program with a specialized team of paramedics and emergency medical technicians (EMTs). This team is trained in USG PIV access to assist with patients that have difficult intravenous access (DIVA) both in the ED and throughout the academic medical center. Methods: This descriptive report details the implementation, development, and evolution of a highly skilled vascular access team trained in USG PIV placement at a single academic center. Under the guidance of ultrasound fellowship trained, board-certified Emergency Medicine (EM) ultrasound faculty, ED paramedics and EMTs are provided comprehensive training and oversight of USG PIV placement. Program description, patient selection, and billing capture are described. This report met Institutional Review Board exemption criteria as a descriptive quality improvement project. Conclusions: This report details the formation and maintenance of a highly skilled vascular access team. The team is comprised of paramedics and EMTs who have been trained in USG PIV placement allowing them to care for patients with DIVA. The evolution of this team has allowed the development of a tiered approach to vascular access and vascular preservation throughout the organization, benefitting both patients and hospital staff.
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spelling doaj-art-88651a6605b84d71a674e964cd8e87be2025-08-20T02:11:57ZengCINQUILL Medical Publishers Inc.POCUS Journal2369-85432025-04-01100110.24908/pocusj.v10i01.18274Health System Impact of Emergency Department-based Vascular Access Program in Patients with Difficult Intravenous AccessNathan P Roll0Shilpa Raju1https://orcid.org/0009-0001-4356-5832Micah Ownbey2Jamal Jones3https://orcid.org/0009-0006-3951-262XChristy Hopkins4https://orcid.org/0009-0006-4748-3355Jennifer Cotton5Department of Emergency Medicine, University of Utah Health, Salt Lake City, UT, USADepartment of Emergency Medicine, University of Utah Health, Salt Lake City, UT, USADepartment of Emergency Medicine, University of Utah Health, Salt Lake City, UT, USADepartment of Emergency Medicine, University of Utah Health, Salt Lake City, UT, USAUniversity of Utah HealthDepartment of Emergency Medicine, University of Utah Health, Salt Lake City, UT, USA Background: Ultrasound guided (USG) peripheral intravenous (PIV) access is a vital use of point of care ultrasound (POCUS) that decreases time to access, reduces need for more invasive access, preserves vasculature, and improves patient experience. Objectives: We describe the impact of an Emergency Department (ED) based vascular access program with a specialized team of paramedics and emergency medical technicians (EMTs). This team is trained in USG PIV access to assist with patients that have difficult intravenous access (DIVA) both in the ED and throughout the academic medical center. Methods: This descriptive report details the implementation, development, and evolution of a highly skilled vascular access team trained in USG PIV placement at a single academic center. Under the guidance of ultrasound fellowship trained, board-certified Emergency Medicine (EM) ultrasound faculty, ED paramedics and EMTs are provided comprehensive training and oversight of USG PIV placement. Program description, patient selection, and billing capture are described. This report met Institutional Review Board exemption criteria as a descriptive quality improvement project. Conclusions: This report details the formation and maintenance of a highly skilled vascular access team. The team is comprised of paramedics and EMTs who have been trained in USG PIV placement allowing them to care for patients with DIVA. The evolution of this team has allowed the development of a tiered approach to vascular access and vascular preservation throughout the organization, benefitting both patients and hospital staff. https://ojs.library.queensu.ca/index.php/pocus/article/view/18274USG IV placementDifficult Intravenous AccessPOCUS
spellingShingle Nathan P Roll
Shilpa Raju
Micah Ownbey
Jamal Jones
Christy Hopkins
Jennifer Cotton
Health System Impact of Emergency Department-based Vascular Access Program in Patients with Difficult Intravenous Access
POCUS Journal
USG IV placement
Difficult Intravenous Access
POCUS
title Health System Impact of Emergency Department-based Vascular Access Program in Patients with Difficult Intravenous Access
title_full Health System Impact of Emergency Department-based Vascular Access Program in Patients with Difficult Intravenous Access
title_fullStr Health System Impact of Emergency Department-based Vascular Access Program in Patients with Difficult Intravenous Access
title_full_unstemmed Health System Impact of Emergency Department-based Vascular Access Program in Patients with Difficult Intravenous Access
title_short Health System Impact of Emergency Department-based Vascular Access Program in Patients with Difficult Intravenous Access
title_sort health system impact of emergency department based vascular access program in patients with difficult intravenous access
topic USG IV placement
Difficult Intravenous Access
POCUS
url https://ojs.library.queensu.ca/index.php/pocus/article/view/18274
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