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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:651-656 • 0278-4297

Technical Advance

Peripherally Inserted Central Catheter Placement With the Sonic Flashlight

Initial Clinical Trial by Nurses

David Wang, PhD, MD, Nikhil Amesur, MD, Gaurav Shukla, BS, Angela Bayless, RN, David Weiser, BS, Adam Scharl, Derek Mockel, Christopher Banks, RN, Bernadette Mandella, RN, Roberta Klatzky, PhD and George Stetten, MD, PhD

Departments of Biomedical Engineering (D.Wa.) and Psychology (R.K.) and Robotics Institute (G.St.), Carnegie Mellon University, Pittsburgh, Pennsylvania USA; Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania USA (N.A., G.St.); and Departments of Nursing, (A.B., C.B., B.M.) and Bioengineering (G.Sh., A.S., D.M., G.St.), University of Pittsburgh, Pittsburgh, Pennsylvania USA.

Address correspondence to George Stetten, MD, PhD, Department of Bioengineering, University of Pittsburgh, 761 Benedum Hall, Pittsburgh, PA 15261 USA., E-mail: stetten{at}pitt.edu

Objective. We describe a case series constituting the first clinical trial by intravenous (IV) team nurses using the sonic flashlight (SF) for ultrasound guidance of peripherally inserted central catheter (PICC) placement. Methods. Two IV team nurses with more than 10 years of experience with placing PICCs and 3 to 6 years of experience with ultrasound attempted to place PICCs under ultrasound guidance in patients requiring long-term IV access. One of two methods of ultrasound guidance was used: conventional ultrasound (CUS; 60 patients) or a new device called the SF (44 patients). The number of needle punctures required to gain IV access was recorded for each patient. Results. In both methods, 87% of the cases resulted in successful venous access on the first attempt. The average number of needle sticks per patient was 1.18 for SF-guided procedures compared with 1.20 for CUS-guided procedures. No significant difference was found in the distribution of the number of attempts between the two methods. Anecdotal comments by the nurses indicated the comparative ease of use of the SF display, although the relatively small scale of the SF image compared with the CUS image was also noted. Conclusions. We have shown that the SF is a safe and effective device for guidance of PICC placement in the hands of experienced IV team nurses. The advantage of placing the ultrasound image at its actual location must be balanced against the relatively small scale of the SF image.

Key Words: central catheter • image-guided intervention • intravenous • sonic flashlight • ultrasound

Abbreviations: CUS, conventional ultrasound • IR, interventional radiology • IV, intravenous • OLED, organic light-emitting diode • PICC, peripherally inserted central catheter • SF, sonic flashlight

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Copyright © 2009 by the American Institute of Ultrasound in Medicine.