Static Ultrasound Guidance for Radial Arterial Puncture (STATIC-US)

Static Ultrasound-Guided Versus Conventional Palpation Techniques for Radial Arterial Puncture in the Emergency Department: A Randomized Controlled Trial

Radial arterial puncture is a commonly performed procedure in emergency departments for arterial blood gas analysis and invasive hemodynamic monitoring. The conventional palpation technique may be associated with prolonged procedure duration and multiple puncture attempts, particularly in patients with weak arterial pulsation or difficult vascular anatomy.

Ultrasound guidance has been proposed as a method to improve procedural success. This randomized controlled trial aimed to compare the static ultrasound-guided technique with the conventional palpation technique for radial arterial puncture in adult emergency department patients.

The primary outcome was puncture duration. Secondary outcomes included first-attempt success rate, total number of attempts, procedure-related complications, and patient pain scores.

Study Overview

• Status: Completed
• Conditions: Arterial Blood Gas Analysis
• Intervention / Treatment: Procedure: Static Ultrasound-Guided Radial Arterial Puncture; Procedure: Conventional Palpation Technique

Detailed Description

Radial arterial puncture is frequently performed in emergency departments for arterial blood gas sampling and invasive arterial pressure monitoring. Although the conventional palpation technique is widely used, procedural failure, prolonged puncture duration, and repeated attempts remain common problems, especially in patients with difficult vascular access.

Ultrasound-guided vascular access techniques have demonstrated improved success rates in several vascular procedures. However, evidence regarding the effectiveness of the static ultrasound-guided method for radial arterial puncture in emergency department settings remains limited.

This prospective randomized controlled trial was conducted in the emergency department of University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital. Adult patients requiring radial arterial puncture were randomly assigned to either the static ultrasound-guided group or the conventional palpation group.

In the static ultrasound-guided group, the radial artery location was identified using ultrasonography prior to skin puncture, and the puncture site was marked externally. In the conventional group, arterial puncture was performed using anatomical landmarks and palpation alone.

The primary outcome of the study was puncture duration. Secondary outcomes included first-attempt success, total number of puncture attempts, procedure-related complications, and patient-reported pain scores.

The study aimed to evaluate whether the static ultrasound-guided technique could improve procedural efficiency and success compared with the conventional palpation technique in emergency department practice.

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kağıthane
    • Istanbul, Kağıthane, Turkey (Türkiye), 34413
      • Adem Melekoglu, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adult patients aged 18 years and older
• Patients requiring radial arterial puncture in the emergency department
• Patients who provided informed consent

Exclusion Criteria:

• Patients younger than 18 years
• Known vascular abnormalities or previous vascular surgery involving the puncture site
• Local infection or skin lesion at the puncture site
• Hemodynamic instability requiring immediate intervention
• Inability to provide informed consent
• Previous enrollment in the study

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Static Ultrasound-Guided Group; Participants underwent radial arterial puncture using the static ultrasound-guided technique. The radial artery was identified with ultrasonography prior to puncture, and the puncture site was externally marked before needle insertion.	Procedure: Static Ultrasound-Guided Radial Arterial Puncture; Static ultrasound guidance was used to identify and externally mark the radial artery location prior to arterial puncture.
Active Comparator: Conventional Palpation Group; Participants underwent radial arterial puncture using the conventional palpation technique based on anatomical landmarks and arterial pulse palpation.	Procedure: Conventional Palpation Technique; Radial arterial puncture was performed using anatomical landmarks and palpation without ultrasound guidance

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Puncture Duration		Immediately after the procedure
Puncture Duration	Time required to successfully complete radial arterial puncture, measured from skin contact of the needle to successful arterial blood aspiration.	At completion of the arterial puncture procedure or after a maximum of three puncture attempts

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
First-Attempt Success Rate	Successful radial arterial puncture achieved on the first needle insertion attempt.	During the procedure

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Score	Patient-reported procedural pain measured immediately after arterial puncture using a 10-point Visual Analog Scale (VAS), where 0 indicates no pain and 10 indicates the worst imaginable pain.	Immediately after completion of the arterial puncture procedure

Collaborators and Investigators

• Sponsor: Sisli Hamidiye Etfal Training and Research Hospital

Publications and helpful links

Helpful Links

• Şişli Hamidiye Etfal Training and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): April 5, 2023
• Primary Completion (Actual): May 5, 2023
• Study Completion (Actual): June 5, 2023

Study Registration Dates

• First Submitted: May 21, 2026
• First Submitted That Met QC Criteria: May 28, 2026
• First Posted (Actual): June 4, 2026

Study Record Updates

• Last Update Posted (Actual): June 4, 2026
• Last Update Submitted That Met QC Criteria: May 28, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Ultrasound-Guided Vascular Access
• Other Study ID Numbers: SHEAH-ED-2026-001; 3870 (Other Identifier: Sisli Hamidiye Etfal Clinical Research Ethics Committee)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data are not planned to be shared because of institutional data protection policies and patient confidentiality considerations.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No