Using a Vein Locator for Pediatric PICC Insertion Can Increase Puncture Efficiency and Improve Pain Management

Background: The peripherally inserted central catheter (PICC) plays an important role in clinical work. However, inserting PICCs, especially in infants and young children, is often challenging. This study aimed to evaluate the application of a venous locator for PICC insertion in children. Methods: This study reviewed pediatric patients who underwent PICC insertion from January 2019 to December 2020 in the Department of Pediatric Surgery, Xinhua Hospital affiliated with Shanghai Jiaotong University, School of Medicine. Among the patients, 176 underwent the traditional procedure and 179 underwent the venous locator–assisted procedure. The venous locator used in our center is the AV400 (AccuVein, USA). We compared the basic characteristics of the two groups, vein selection, procedure duration, number of insertion attempts, pain score evaluations, PICC‐related complications, family member satisfaction, and other parameters. Results: The proportion of multiple puncture attempts during insertions was significantly lower in the locator group than in the traditional method group (control group, p < 0.001). The success rate of first‐attempt punctures in non–first‐time catheterized children was higher when using the vein locator ( p < 0.001). The venous locator also increased the success rate of insertions in low‐weight children. Additionally, the locator group experienced fewer cases of PICC‐related phlebitis ( p = 0.029). There was no significant difference in other complications, such as catheter‐related infections, thrombosis, catheter blockage, catheter displacement, catheter breakage, puncture site exudate, or accidental catheter removal. The use of a venous locator also decreased the pain experienced by children under 12 months of age ( p = 0.043) and significantly improved the satisfaction of family members ( p = 0.006). Conclusions: For pediatric patients who undergo PICC insertion, the use of a vein locator can reduce the number of multiple puncture attempts and improve puncture efficiency in non–first‐time catheterized patients. This approach, to some extent, lowers PICC‐related complications and thus merits clinical application.