Color Doppler and Peripheral Venous Catheters

Confirmation of adequate peripheral intravenous catheter placement should be determined
before using the parenteral route; however, there is no gold standard universally accepted
for this purpose. Determination of the correct position of freshly inserted peripheral
intravenous catheters and already established intravenous lines depends largely on subjective
clinical signs such as visual evidence of swelling around the insertion site, low resistance
to infusion and free back-flow of blood. Ultrasound-guided cannulation of peripheral veins
has gained popularity in recent years and is standard of practice in some institutions.
Primarily used in guiding central line placement, the applications of ultrasound for vascular
access continue to expand in the perioperative setting, thanks to its easy use,
non-invasiveness and safety profile. On the other hand, utilization of color Doppler
technology with flow injection test has been shown to be a valuable tool for early
recognition of malfunctioning intravenous catheters. The color Doppler flow technique is both
safe and reliable, and aids in identification of correct intravascular position of venous
catheters in children.

This study aims to test the hypothesis that the color Doppler flow technique is superior to
standard clinical techniques (free flow from a hanging intravenous fluid bag, aspiration of
venous blood with syringe, and non-obstructed hand injection of 2 mL of normal saline) to
detect the correct position of peripheral intravenous catheters in adult surgical patients.

Inclusion Criteria:

- Age >18 years undergoing elective surgery with an indwelling peripheral venous
catheter.

Exclusion Criteria:

- Patients with open wounds in the vicinity of the intravenous line insertion site or
scar tissue on the extremity, as well as those with dressings, bandages, or casts on
the extremity precluding adequate use of ultrasound.