Impact of Ultrasound-Guided Peripheral Intravenous Training on Central Line Placement in the Emergency Department.
- 1Riverside Regional Medical Center, Department of Emergency Medicine, Newport News, Virginia.
Abstract
Introduction
Central venous catheters are placed in the emergency department (ED) when difficult peripheral access limits care or when critical medications require central access because of their sclerotic nature or incompatibility with other drugs. Ultrasound-guided peripheral intravenous (IV) access offers a less invasive alternative. We evaluated whether implementation of a structured ultrasound-guided peripheral intravenous training program for ED nurses and technicians was associated with changes in ED central venous catheter use.Methods
We performed a retrospective chart review at our 50-bed academic community ED, which holds a Level II trauma designation. This center has an ED census of 80,000 patients per year, a 4:1 nursing to patient ratio with an admission rate of 20-25% with expected monthly variation. A structured ultrasound-guided peripheral IV curriculum for nurses and technicians launched in November 2023. The primary endpoint was annual ED central venous catheter placement count, identified through procedure documentation in the electronic health record. Training that was conducted for nurses and clinical technicians consisted of three hours of didactic and hands-on training, followed by a period of procedural supervision. We compared the baseline year 2022 with the first two full post-implementation years, 2024 and 2025. The analysis was descriptive.Results
Central venous catheter placements in the ED decreased from 387 in 2022 to 275 in 2024 and 218 in 2025, corresponding to absolute reductions of 112 placements (28.9%) and 169 placements (43.7%), respectively. By the end of 2025, 33 nurses and ED technicians had completed training and competency sign-off.Conclusion
Implementation of a structured ultrasound-guided peripheral IV training program for nurses and technicians was associated with fewer ED central venous catheter placements at our institution. These findings support further multicenter evaluation using patient-level outcomes and visit-adjusted rates.
Related
- Ultrasound guidance versus near-infrared light versus the standard technique for first-attempt success of peripheral intravenous catheterisation in adults with difficult venous access in a medical imaging department (RÉUSSIR-VVP): protocol for a single-centre, three arms, randomised controlled trial
- Development and external validation of a risk prediction model for early peripheral intravenous catheter failure in outpatients and emergency department patients receiving consecutive infusion therapy.
- Emergency Department or Ward? Does the Insertion Environment Influence Bloodstream Infection Risk After Central Venous Catheter Placement?
- Clinical Outcomes Associated With Intravenous Fluid Shortages in Emergency Department Patients: A Propensity Score Matched Cohort Study
- A non-inferiority randomized controlled trial comparing nebulized fentanyl and intravenous morphine for acute pain management in the emergency department.
BibTeX
@article{berniard2026impact,
title = {{Impact of Ultrasound-Guided Peripheral Intravenous Training on Central Line Placement in the Emergency Department.}},
author = {Matthew Berniard and Richard Slama and Gavin Rogers and Elena Garrett and Chandler Davis and John Alex},
journal = {The western journal of emergency medicine},
year = {2026},
month = sep,
doi = {10.5811/westjem.58319},
url = {https://europepmc.org/article/MED/42900942},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of Ultrasound-Guided Peripheral Intravenous Training on Central Line Placement in the Emergency Department.
AU - Matthew Berniard
AU - Richard Slama
AU - Gavin Rogers
AU - Elena Garrett
AU - Chandler Davis
AU - John Alex
PY - 2026
DA - 2026/09/09
JO - The western journal of emergency medicine
DO - 10.5811/westjem.58319
UR - https://europepmc.org/article/MED/42900942
AB - Introduction Central venous catheters are placed in the emergency department (ED) when difficult peripheral access limits care or when critical medications require central access because of their sclerotic nature or incompatibility with other drugs. Ultrasound-guided peripheral intravenous (IV) access offers a less invasive alternative. We evaluated whether implementation of a structured ultrasound-guided peripheral intravenous training program for ED nurses and technicians was associated with changes in ED central venous catheter use.Methods We performed a retrospective chart review at our 50-bed academic community ED, which holds a Level II trauma designation. This center has an ED census of 80,000 patients per year, a 4:1 nursing to patient ratio with an admission rate of 20-25% with expected monthly variation. A structured ultrasound-guided peripheral IV curriculum for nurses and technicians launched in November 2023. The primary endpoint was annual ED central venous catheter placement count, identified through procedure documentation in the electronic health record. Training that was conducted for nurses and clinical technicians consisted of three hours of didactic and hands-on training, followed by a period of procedural supervision. We compared the baseline year 2022 with the first two full post-implementation years, 2024 and 2025. The analysis was descriptive.Results Central venous catheter placements in the ED decreased from 387 in 2022 to 275 in 2024 and 218 in 2025, corresponding to absolute reductions of 112 placements (28.9%) and 169 placements (43.7%), respectively. By the end of 2025, 33 nurses and ED technicians had completed training and competency sign-off.Conclusion Implementation of a structured ultrasound-guided peripheral IV training program for nurses and technicians was associated with fewer ED central venous catheter placements at our institution. These findings support further multicenter evaluation using patient-level outcomes and visit-adjusted rates.
SN - 1936-900X
SN - 1936-9018
ER -