Ultrasound Guided IV Access in a Pediatric Emergency Department (USgIV)

May 10, 2018 updated by: Children's Hospital of Philadelphia

A Randomized Control Trial of Ultrasound Guided IV Access in the Pediatric Emergency Department

The primary objective is to determine whether the use of ultrasound guidance compared to standard IV access improves the proportion of successful IV placement on a first attempt for children in a pediatric emergency department who have predicted difficult access by a validated score. Secondary objectives include determining whether ultrasound-guided IV access lowers the overall number of IV attempts and/or reduces time to IV access. The investigators will also examine the duration of IV access and any complications related to IV access in both the traditional and ultrasound guided IV access group.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The proposed study is a randomized trial of ultrasound guided IV access compared to traditional IV access in patients determined to have difficult IV access based on the Difficult Intravenous Access (DIVA) scale. Patients enrolled in the study will be randomized to traditional IV access or ultrasound guided IV access. If randomized to ultrasound guided IV access, the IV will be placed under direct visualization. Following IV placement or when attempts at IV access have ceased, the patient and family will be asked to complete a series of questions related to their satisfaction regarding IV placement. The follow-up phase examining duration of the IV and any related complications will continue until the IV placed as part of the study has been removed.

Study Type

Interventional

Enrollment (Actual)

163

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Pennsylvania
      • Philadelphia, Pennsylvania, United States, 19104
        • The Children's Hospital of Philadelphia

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

No older than 18 years (Child, Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Emergency department patients ages 0-18 years
  • Requiring IV access as determined by emergency department attending physician
  • Predicted difficult IV access as defined by a revised DIVA score >3

Exclusion Criteria:

  • Unstable patients triaged as a Level 1 triage acuity
  • Patients who refuse IV access
  • Non-English speaking parent/guardian
  • No study team member available to enroll patient
  • Parent/guardian does not consent
  • Allergy to ultrasound gel

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Ultrasound guided intravenous access
This group will have their IV placed by ultrasound guidance.
Procedure: Ultrasound guidance
The ultrasound machine will be used to guide intravenous line placement in patients randomized to the ultrasound guided intravenous line group
Placebo Comparator: Traditional intravenous access
The patients randomized to traditional IV access will have their IVs placed by standard technique.
Procedure: Traditional intravenous access
Placement by experienced nurse using standard IV techniques
Other Names:
  • Standard of Care arm

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Success of Initial IV Placement Attempt
Time Frame: Participants will be followed through the duration of emergency department stay, an expected average of 4 hours
Patients will be randomized to traditional IV placement or ultrasound guided IV placement immediately after enrollment. The IV will be placed directly following enrollment.
Participants will be followed through the duration of emergency department stay, an expected average of 4 hours

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Measure the overall number of IV attempts..
Time Frame: Participants will be followed through the duration of emergency department stay, an expected average of 4 hours
We will record the number of IV attempts made until a patient has a successfully placed IV or further attempts are aborted.
Participants will be followed through the duration of emergency department stay, an expected average of 4 hours
Time to IV access.
Time Frame: Participants will be followed through the duration of emergency department stay, an expected average of 4 hours
The time from enrollment until successful IV access is obtained will be measured.
Participants will be followed through the duration of emergency department stay, an expected average of 4 hours
Patient & family satisfaction with IV placement method.
Time Frame: Participants will be followed through the duration of emergency department stay, an expected average of 4 hours
A survey will be given to parents and patients over age 12 years to ask them about their experience with the IV placement.
Participants will be followed through the duration of emergency department stay, an expected average of 4 hours
Compare the survival (in length of time) of IV access
Time Frame: Participants will be followed through the duration of hospital stay, expected average of 5 days
We will track the IVs placed as part of the study through the electronic medical record to determine when and why they were removed and if there were any associated complications.
Participants will be followed through the duration of hospital stay, expected average of 5 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Children's Hospital of Philadelphia

Investigators

  • Principal Investigator: Joseph J Zorc, MD, MSCE, Children's Hospital of Philadelphia

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

May 1, 2014

Primary Completion (Actual)

December 2, 2016

Study Completion (Actual)

March 1, 2017

Study Registration Dates

First Submitted

April 24, 2014

First Submitted That Met QC Criteria

April 28, 2014

First Posted (Estimate)

April 29, 2014

Study Record Updates

Last Update Posted (Actual)

May 15, 2018

Last Update Submitted That Met QC Criteria

May 10, 2018

Last Verified

May 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 13-010758

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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