Observational study at the time of peripheral venous catheter placement using the ultrasonography and qualitative sketching method

Abstract

 This study aimed to describe the relationship between inappropriate conditions due to multiple puncture attempts for catheterization and thrombus formation with subcutaneous edema at catheter failure by qualitative analysis and ultrasonography. Seven categories were extracted, and two stories were identified using qualitative-descriptive analyses. First, when attempting multiple insertions, ＜puncture sites＞ were chosen, such as the ulnar side and dorsum of the hand, while ＜visual judgment of target vein＞ was difficult, and the ＜posture at insertion＞ was contorted. The catheters were not inserted parallel to the sagittal plane, and the echo image confirmed that ＜intravascular position of catheter tip＞ were not parallel to the vessels. Second, with IV cannulation on the radial side, during manipulation of the ＜securement by dressing films＞, the mesh part of the IV dressing covered the connector area and caused it to sink into the patient’s skin in the ＜peripheral condition of the hubs/connectors attached to the apparatus＞. These phenomena were observed in many echo images in which the tip of the catheter was placed in the upstream direction of the blood vessels. Our results suggested that the posture of the body during insertion and the securement methods could affect thrombus and edema formation, since mechanical stimuli affected the blood vessels and subcutaneous tissue.