Sonographer Performed Vascular Access and Injection of Local Anaesthetic: A Clinical Audit of Peripherally Inserted Central and Midline Catheters

ABSTRACT Introduction Ultrasound is commonly used to guide placement of peripherally inserted central and midline catheters, and local anaesthetic (LA) can be administered to allow patient tolerance of this procedure. The success rate of sonographers performing this vascular access procedure and the safety of sonographers administering LA were investigated. Methods A retrospective clinical audit was conducted at a single tertiary public hospital in Australia. One thousand one hundred and forty procedures were audited which were performed over an 18‐month period. The rate of successful vascular access and catheter tip placement by sonographers was compared to that of nurses, registrars and interventional radiologists. Additionally, the reaction rate to LA administration by the same range of health professionals was also compared. Results Sonographers successfully performed ultrasound‐guided peripherally inserted central catheters (PICC) and midline catheter procedures, with procedural success rates comparable to those of other health professionals ( p > 0.05). Mean Lidocaine 1% doses varied by inserter group. Sonographers (mean 14.8 mg, SD 7.5, n = 723) and nurses (mean 17.3 mg, SD 8.2, n = 218) administered lower average LA doses compared to registrars (mean 29.9 mg, SD 14.7, n = 154) and interventional radiologists (mean 31.4 mg, SD 17.5, n = 25). Conclusion Sonographers, when appropriately trained, can safely perform ultrasound‐guided vascular access procedures involving LA administration. Extended scope of practice models for sonographers in Australia are required.