New Project Proposal Form
Physician Name: Michael Witting
Date June 25, 2006
Project Title: Should I Try This Vein? Factors Influencing Success in Emergency
Department Ultrasound-Guided Antecubital Vein Catheterization
Please indicate as many PICO elements as possible:
(P)
(I)
(C)
(O)
Patients: ED patients requiring US-guided peripheral access
Intervention: none (no study-related intervention – patients already getting US)
Comparison: several – see below
Outcome: success/failure (dichotomous)
Dependent variable: success/failure
Independent variable(s): size of vein, depth of vein, experience of operator, education of
operator
Your research question (incorporate PICO into a question)
In emergency department patients requiring ultrasound-guided antecubital IV access,
what factors (among vein- and operator-related characteristics) predict success?
Example: In UMMS patients with abdominal pain who are sent for CT (P), does the use
of IV and oral contrast (I) increase the mean length of ED stay (O) compared with noncontrasted scanning (C)?
Background (summarize prior literature, include a few key references)
When ultasound-guided ED antecubital access is indicated, failed attempts are common,
resulting in pain to patients. On the one hand, some veins may be too small or too deep
to expect success, especially in inexperienced operators. In these cases, the operator may
consider looking elsewhere (the other arm or deep veins) for access, rather than
attempting a venipuncture that is unlikely to succeed. On the other hand, some larger
shallower veins may be suitable for inexperienced operators.
In this study, we wish to determine the effects of vein size and depth, as well as operator
experience, on success rate.
In a literature search, we were unable to find a study that has specifically examined
success rates for ED ultrasound-guided antecubital catheterization.
Brief Proposed Methods
Recording of important factors with each attempt (size and depth of vein, operator
experience with ultrasound, etc.). Analysis by chisquare for individual variables and
logistic regression for multiple variables, using the success/failure as the dependent
variables.