Peripheral venous catheterization (PVC) is the most common invasive procedure in healthcare worldwide. Improving the success rate of PVC on the first attempt is crucial for patients, as it impacts pain, anxiety, the risk of extravasation, rapid access to care, and the patient-provider relationship. For healthcare providers, a higher success rate enhances self-confidence and autonomy, while institutions benefit from improved reputation and reduced costs.
In the Poitiers hosptial, one in ten catheters is used in imaging services, with CT scan departments accounting for 66.3% of catheter usage due to iodinated contrast injections. Literature suggests two techniques to enhance PVC success: ultrasound-guided and infrared illumination methods. These techniques appear effective primarily for patients with difficult venous access. Additionally, the A-DIVA clinical score has been developed to predict first-attempt success rates. However, no studies in Europe have compared the effectiveness of these two techniques in imaging settings or based on the A-DIVA score. This study aims to identify the most effective technique for PVC in patients with difficult venous access.
Patients aged 18 or over
Patient with a CT scan appointment and a medical prescription requiring a peripheral venous line.
Patient with an A-DIVA score greater than or equal to 2.
Patient able and willing to comply with all study procedures.
Arm with arteriovenous fistula
Limb with an orthopaedic or vascular prosthesis
Previous mastectomy, axillary lymph node dissection or homolateral radiotherapy of the arm
Paralysed limb
Parallel
Infrared peripheral venous technique
Other interventionuse a infrared device for venous peripheral visualisation and catheter insertion
Ultrasound-guided peripheral venous technique
Other interventionUse the ultrasound-guided technique for venous peripheral visualisation and catheter insertion
Landmark technique
Other interventionthe gold standard technique with observationnal and palpation
The proportion of patients with a successful catheterization at the first attempt
Success of the cathetherization is defined by a functional cathether without immediate complication : absence of pain expressed by the patient, or visible oedema (absence of signs of diffusion or haematoma)
Proportion of patients with successful cathetherization at the second attempt (in case of failure of the first attempt)
Success of the cathetherization is defined by a functional cathether without immediate complication : absence of pain expressed by the patient, or visible oedema (absence of signs of diffusion or haematoma)
The number of attempts
The number of attempts will be assessed by the number of breach of the skin barrier by a catheter
The maximum pain felt by the patient during the attempts
Maximum pain will be assessed using a numerical rating scale ranging from 0 to 10. Higher score stands for a better outcome.
Overall satisfaction of the patient
Satisfaction will be assessed using a numerical rating scale ranging from 0 to 10. Higher score stands for a better outcome.
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