Ultrasound approach to patients with difficult venous catheterization by emergency nurses. A Systematic review.

  • Diego Lefons Specialized Nurse
  • michele angelo milatino, sgambati, dott.
  • francesco guidotti, Dott.


Background: The insertion of peripheral venous access is the invasive procedure that occurs most frequently in hospital facilities and is essential in order to guarantee continuity of care and administration of therapy. The standard technique in a DIVA patient is not efficient causing traumatic experiences, increasing time and waste.

Methods: A systematic review was performed after searching the Scopus, Pubmed and Cinahl databases, with the following keywords: “ultrasound AND intravenous AND nurse”. Initially, 1093 articles were identified and after carrying out a selection, 19 articles were taken into consideration.

Results: Among the selected articles, various themes emerged, including: high success rates in DIVA patients; risk factors associated with difficult patients; the consequences related to the lack of a specialized team and the numerous advantages that derive from the routine placement of the appropriate devices with the USGPIVA technique. The high success rate of the ultrasound-guided technique is related to the experience of the nurse who performs it. The use of ultrasound would make it possible to: increase patient compliance and the speed of assistance; reduce traumatic experiences, economic waste, material waste and CVC placement. To find long-lasting access it is essential: identifying the right vein and choosing the right device.

Conclusions: The review of the literature led to the confirmation that the USGPIVA is the best technique to obtain peripheral venous access in DIVA patients. To increase the quality of care provided and reduce waste, it is essential to identify difficult patients early and have qualified staff