Evaluating the Implementation of Biplane Ultrasound Probes for Guided Peripheral Intravenous Access in the Emergency Department

Single-plane ultrasound (US) probes are commonly used to initiate ultrasound-guided peripheral intravenous (USGPIV) access for patients with difficult intravenous access (DIVA) in the emergency department (ED), although their use is not yet standardized across all EDs. This pilot project introduced the use of a biplane US probe for USGPIV access at a Level 1 Trauma Center ED. Following the training of 10 registered nurses (RNs) in the application of biplane US probes, the project aimed to decrease reliance on ED providers (e.g., NPs, PAs, and physicians) for USGPIV insertions in DIVA patients, allowing providers to focus on other critical tasks and improving patient care efficiency. Primary outcomes measured included the average number of attempts required, progression to critical care access devices, ED patient flow times, and RN utilization rates of the biplane US probe post-training. Results showed that the biplane method improved outcomes compared to the single-plane method, with a 23.8% decrease in the average number of attempts required to obtain access, an 80% decrease in subsequent critical care vascular access placement, and an increase in the rate of both single-plane and biplane US probe use after training compared to baseline. While ED flow rate did not improve, this pilot project demonstrated that biplane US probes for USGPIV access in the ED setting improve patient outcomes.