Difficult IV access: Is ultrasound-guided cannulation the answer?

Many healthcare professionals may recognise the common scenario of peripheral intravenous (IV) catheter insertion on a patient with difficult intravenous (IV) access without previous specialised training.

Though considered the most common invasive procedure in modern healthcare, peripheral IV catheter insertion is not always successfully executed, and repeated attempts can decrease patient comfort and satisfaction while raising infection risks, costs and workload for the healthcare team.1,2

According to Dr Rick van Loon, Nurse Anaesthetist at the Catharina Hospital and Research Lecturer at the Fontys University of Applied Sciences in Eindhoven, Netherlands, ultrasound-guided cannulation may be the solution to combatting peripheral IV catheter insertion complications, notably in patients with difficult IV access.3

Follow Dr van Loon in his presentation at the 2022 BD Multidisciplinary Advanced Course on Vascular Access (MACOVA) to learn more about ultrasound-guided cannulation and how to train your teams on the practice:*

Register to read the full article and watch Dr Van Loon’s presentation.


  1. Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but Unacceptable: Peripheral IV Catheter Failure. J Infus Nurs. 2015; 38(3):189–203. https://doi.org/10.1097/NAN.0000000000000100
  2. Morrell, E. Reducing Risks and Improving Vascular Access Outcomes. J Infus Nurs. 2020 Jul; 43(4): 222–228. Epub 9 Jul 2020. doi: 10.1097/NAN.0000000000000377
  3. Van Loon F. Ultrasound-Guided Cannulation: The learning curve for ultrasound-guided insertion of peripheral intravenous catheters in adult patients. Lecture presented at: The 2022 BD Multidisciplinary Advanced Course on Vascular Access (MACOVA); 8 June 2022; Berlin, Germany.
  4. Van Loon F, Buise M, Claassen J, Dierick-van Daele A, and Bouwman R. Comparison of ultrasound guidance with palpation and direct visualization for peripheral vein cannulation in adult patients: a systematic review and meta-analysis. Br J Anaesth. 2018;121(2):358-366. doi: 10.1016/j.bja.2018.04.047
  5. Van Loon F et al. Establishing the required components for training in ultrasound-guided peripheral intravenous cannulation: a systematic review of available evidence. Med Ultrason. 2019:21(4);464-473. Doi: 10.11152/mu-2120.
  6. Van Loon F, Scholten H, Korsten H, Dierick-van Daele A, and Bouwman R. The learning curve for ultrasound-guided peripheral intravenous cannulation in adults. Med Ultrason. 2022 May 25;24(2):188-195. doi: 10.11152/mu-3322. Epub 2022 Jan 11.


The presentation is made on behalf of BD and contains the opinions, techniques and practices by Dr Rick Van Loon.  The opinions and techniques presented herein are for informational purpose only.  

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