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Ultrasound Guided Peripheral Intravenous Line Placement Using the Incremental Advancement Method

Chapter 4 discusses the dynamic use of ultrasound to guide the placement of a peripheral intravenous (IV) line. Ultrasound can be used to guide placement of multiple types of vascular access. Arteries and veins are sonographically similar in cross section: hyperechoic circles with hypoechoic interiors. Arteries are thicker walled and characteristically pulsatile. Veins are more susceptible to compression. Doppler or color flow can distinguish the amplitude and direction of flow. Skill with placing peripheral ultrasound guided IV lines in patients with difficult IV access can often help the practitioner avoid the need to place a central line, assuming the central line is not needed for other indications.