A survey of paediatric difficult peripheral intravenous access in the emergency department and use of point‐of‐care ultrasound

Introduction/Purpose Peripheral intravenous catheter (PIVC) insertion can be challenging in children, with point-of-care ultrasound (POCUS) known to increase success rates. The objective of this study was survey how emergency department (ED) clinicians identify and escalate paediatric patients difficult access (DIVA), specifically the use POCUS. Methods This cross-sectional conducted an Australian academic mixed ED that surveyed resident medical officers (RMOs), registrars, consultants senior nurses. A 15 multiple-choice questionnaire evaluated experience PIVC insertion, approach identifying managing DIVA POCUS or other adjuncts. Results Eighty (34.2% response rate) completed survey. Poor vein palpability rated highest predictor DIVA. Of respondents, 19 (86.4%), 28 registrars (90.3%) 16 RMOs (64.0%) used as adjunct for but (72.8%), 21 (67.8%) 20 (80.0%) would less than 25% time clinical practice. Discussion suggests more prefer using factors when patients, rather subjectively gestalt, which relies on clinician experience. Whilst clearly recognised a useful tool our study, infrequently patients. Conclusions There is currently no consistent process identification escalation including adjuncts such Clinician awareness these issues should addressed, include development guidelines training children.