Obtaining intravenous access is difficult in the pediatric population. Ultrasound-guidance allows real-time visualization of target veins which are invisible and impalpable. We hypothesize that the use of ultrasound by a trained nurse team would improve the success rate of peripheral intravenous catheter insertion in pediatric patients with difficult intravenous access, compared to palpation of the vein alone.
For this study, when peripheral intravenous catheterization will be indicated in one of the participating pediatric services for an eligible patient, state-certified nurse investigators, trained in ultrasound guidance, will be contacted. After verification of eligibility criteria and all informed consents obtained, one of the investigators will randomize the patient in one of the 2 treatment groups under study: peripheral intravenous catheterization by visualization and palpation of the vein alone (standard of care) or by ultrasound guidance performed by a trained nurse.
Several outcomes will be measured and compared between the 2 groups (e.g. successful insertion of intravenous catheter, pain, adverse events).
age ≥ 1 month and < 18 years
intravenous catheter insertion indicated for hospital care
DIVA (Difficult Intravenous Access Scale) score ≥ 4
hospitalized in one of the pediatric departments of the Reims University Hospital
Newborns (< 1 month) and premature babies hospitalized in neonatal intensive care, neonatology and maternity units
Known vascular pathology
Hemodialysis with arteriovenous fistula
Unstable hemodynamic and/or respiratory clinical state according to the judgment of the medical team