How to perform ultrasound-guided cannulation in adults

RATIONALE AND KEY POINTS: Peripheral intravenous (IV) cannula insertion is one of the most common procedures performed in hospital patients. Ultrasound-guided cannulation is increasingly used by nurses and other healthcare practitioners to ensure successful cannulation, particularly in patients with difficult intravenous access (DIVA). This article provides nurses with foundational knowledge of ultrasound-guided cannulation before they undertake formal training in the procedure and achieve the required competencies to undertake it independently. • Evidence suggests that nurses who use ultrasound-guided cannulation achieve higher rates of successful first-attempt cannula insertion, with fewer complications and higher patient satisfaction, compared with landmark-based cannulation. • The two generally accepted approaches to ultrasound-guided cannulation are the short axis 'out-of-plane' approach and the long axis 'in-plane' approach, which differ in how the needle is angled relative to the ultrasound beam. • Infection control is paramount when undertaking ultrasound-guided cannulation, and the risk of infection should be mitigated by the use of an aseptic non-touch technique, single-use sterile probe covers and sterile ultrasound gel. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: • How this article might enhance your understanding of the techniques involved in performing ultrasound-guided cannulation. • How you could use this information to educate colleagues on the appropriate technique and evidence base for using ultrasound-guided cannulation.