This is a good question. I have never seen any published results on this topic but it is my belief that it depends on the inserter. Many are very skilled with the needle guide because that is how they were taught to use ultrasound. Many would much rather use free hand and are equally successful with that method. I suspect that there are more PICC nurses using needle guides than free hand but I have not done any research on this topic. This may be a good forum to explore that question.
I was taught free hand and that is how I have continued to place about 10,000 PICCs to date. When teaching PICC placement I have the person learning this new skill use a needle guide so they have the experience with them. More importantly so they can get the feel of the angle just as I used the blue phantom to get the feel of vein identification and the feel of using the ultrasound on a slippery surface. I encourage them to lose their “training wheels” as soon as possible. The leading supplier of needle guides charge $15.00 to $20.00 per needle guide. This is a big expense in today’s healthcare climate for a crutch!
I only have used the needle guide. I do not feel I have the ability to easily and with minimal pain insert a needle and access the vein free hand. I believe I would be doing alot of moving the needle around. I would be very interested in learning more on the skill of using the ultrasound and free hand accessing the veins. I have trouble with the correct ange and depth and where to actually to insert the needle and the angle. I would love any info any one wants to share.
I know many times people ask us to use the ultrasound to start a peripheral and because of my use of the needle guide I do not feel that this would be a pleasant experience for the patient. That is what makes the Bard Ultrasound Prevue sound appealing for peripheral sticks for me.
I did take an online course with tips for ultrasound use for peripheral access but it just did not seem to get me all the info to make me feel comfortable to use it.
Thanks and once again I would love any teaching or information you would share. [email protected]
Sorry - I'm not aware of any data. Our team uses 100% freehand, unless we're training an outside person with a contract asking us to use a needleguide during the training. With freehand, you can slide the probe so that you always are seeing the needle tip, even just upon penetrating the dermis.
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
Our team is 100% freehand as well. We learned that way and have never had exposure to the needle guide. Would think it would hinder rather than help once you get over the initial learning curve.
I start with a needle guide in short axis for exact angle the rotate to long axis while keeping the vein in view then advance into the vein. So both?
This is a good question. I have never seen any published results on this topic but it is my belief that it depends on the inserter. Many are very skilled with the needle guide because that is how they were taught to use ultrasound. Many would much rather use free hand and are equally successful with that method. I suspect that there are more PICC nurses using needle guides than free hand but I have not done any research on this topic. This may be a good forum to explore that question.
Our team is 100% freehand.
Darilyn
I was taught free hand and that is how I have continued to place about 10,000 PICCs to date. When teaching PICC placement I have the person learning this new skill use a needle guide so they have the experience with them. More importantly so they can get the feel of the angle just as I used the blue phantom to get the feel of vein identification and the feel of using the ultrasound on a slippery surface. I encourage them to lose their “training wheels” as soon as possible. The leading supplier of needle guides charge $15.00 to $20.00 per needle guide. This is a big expense in today’s healthcare climate for a crutch!
I only have used the needle guide. I do not feel I have the ability to easily and with minimal pain insert a needle and access the vein free hand. I believe I would be doing alot of moving the needle around. I would be very interested in learning more on the skill of using the ultrasound and free hand accessing the veins. I have trouble with the correct ange and depth and where to actually to insert the needle and the angle. I would love any info any one wants to share.
I know many times people ask us to use the ultrasound to start a peripheral and because of my use of the needle guide I do not feel that this would be a pleasant experience for the patient. That is what makes the Bard Ultrasound Prevue sound appealing for peripheral sticks for me.
I did take an online course with tips for ultrasound use for peripheral access but it just did not seem to get me all the info to make me feel comfortable to use it.
Thanks and once again I would love any teaching or information you would share. [email protected]
Gina Ward R.N., VA-BC
100% freehand...
Sorry - I'm not aware of any data. Our team uses 100% freehand, unless we're training an outside person with a contract asking us to use a needleguide during the training. With freehand, you can slide the probe so that you always are seeing the needle tip, even just upon penetrating the dermis.
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
Our team is 100% freehand as well. We learned that way and have never had exposure to the needle guide. Would think it would hinder rather than help once you get over the initial learning curve.
Keely
Keely Ralston RN-BC, VA-BC, CPUI, RCIS
Does anyone recommend any teaching program or info to learn more about free hand technique? Thanks
Gina Ward R.N., VA-BC