Authors

Miguel Ángel Rodríguez Calero1, Juan José Martínez Moreno2, Antonio González Trujillo2,Ismael Fernández Fernández2, Elena González Fierro2, Roberto Oyarbide Lasarte1

Position

1Enfermero. Unidad de Calidad, docencia e investigación. Hospital de Manacor. Mallorca2Enfermero/a. Servicio de urgencias. Hospital de Manacor. Mallorca

Contact address

Miguel Ángel Rodríguez Calero. Unidad de Calidad, docencia e investigación. Hospital de Manacor. Ctra. Manacor-Alcudia, s/n. 07500 Manacor (Mallorca).

Contact email: ecoguia@hmanacor.org

Abstract

Objective: to find out the factors associated with “difficult venous access” (DVA) in adult patients managed at the Emergency Unit, as well as to describe the use by nurses of ultrasound-assisted puncture techniques (ultrasound-assisted (UA) technique and ultrasound-guided (UG) technique), and the degree of success of each one vs. the traditional catheterization technique.
Method: a descriptive transversal study conducted in adult patients with “difficult venous access” seen at the Emergency Unit of the Hospital de Manacor (Majorca). The nurse conducting the catheterization completed an anonymous record with variables associated with their intervention, the health of the patient, and success in each one of the techniques. The contrast hypothesis tests used to determine association were Mann-Whitney’s U for quantitative variables and Square Chi for categorical variables.
Results: fifty-one (51) cases were studied. The DVA-associated variables were: not finding veins at palpation (72.6%), not finding visible veins (66.7%), previous history of difficulty (66.7%) and >2 failed catheterization attempts (49%). The most common acute factor was hypotension (29.4%), the most usual chronic factors were obesity (45.1%), chemotherapy treatment (29.4%) and diabetes (23.5%). The “blind” technique was used in 40 patients, and ultrasound-assisted techniques were used in 39 cases, which were more effective than the usual approach (p<0.05).
Conclusions: there are signs of the presence of factors associated with difficulty in peripheral puncture; ultrasound techniques offer an effective solution for these cases, leading to a lower number of punctures.

Keywords:

Cateterización venosa periférica; ultrasonografía; ultrasonografía guiada; urgencias; investigación; estudio descriptivo; estudio descriptivo

Versión en Español

Título:

Canalización de vías venosas periféricas difíciles y utilidad de técnicas ecográficas en un Servicio de Urgencias