Evaluating the Accuracy of Point-of-Care Ultrasound for Peripheral Intravenous Cannulation in Emergency and Trauma Patients: A Systematic Review.

This systematic review evaluates the accuracy and effectiveness of point-of-care ultrasound (POCUS) for peripheral intravenous (PIV) line placement in trauma and emergency department patients. PIV access can be challenging in patients with difficult vascular access (DIVA), often leading to delays in care. POCUS has emerged as a promising modality to improve success rates and reduce complications in such scenarios. A comprehensive literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across PubMed, EMBASE, Scopus, and Google Scholar. Five studies met the inclusion criteria, encompassing randomized controlled trials, observational studies, a quality improvement initiative, and a meta-analysis, with a combined total of over 2,800 patients. The findings consistently demonstrated that POCUS significantly improves first-attempt success rates, decreases the number of cannulation attempts, and enhances procedural efficiency. One randomized trial reported a faster median cannulation time with bi-plane imaging (35 seconds vs. 45 seconds, p = 0.03), while a meta-analysis showed a two-fold increase in the odds of first-pass success using ultrasound guidance (OR: 2.1; 95% CI: 1.65-2.7; p < 0.001). Nurse-led POCUS training programs also proved highly effective, achieving post-training success rates above 90%. Despite some limitations, such as heterogeneity in study design, small sample sizes, and mixed pediatric and adult populations, the overall evidence supports the integration of POCUS into emergency protocols for vascular access. The results suggest that routine POCUS use can improve outcomes and workflow, particularly in time-sensitive trauma care.