This video demonstrates an overview of radial arterial cannulation in a pediatric patient using real-time ultrasound (US) guidance. Ultrasound imaging is a useful tool in the armamentarium for guiding arterial line placement, and its use has become commonplace due to increased accessibility and improved technology. Ultrasound imaging facilitates the detection of abnormal anatomy and abnormal findings (e.g. thrombosis). It also allows for real-time guidance for arterial cannulation, which is especially valuable during difficult insertions such as in neonates or small infants, patients with weak or absent pulses or landmarks, and those with multiple prior cannulations. There is evidence of higher success rates with first attempts and decreased complications compared to the traditional landmark and palpation techniques.
This video demonstrates the placement of a central venous catheter (CVC) in the internal jugular vein (IJV) in an infant using real-time ultrasound (US) guidance. Traditionally, the landmark approach has been the technique used to guide CVC placement. Presently, the use of ultrasound (US) for guiding placement has become commonplace due to increased accessibility, improved technology, and evidence of increased first-attempt success rates and decreased complications. Real-time US-guided central venous cannulation is now the recommended technique over the landmark technique by professional organizations. The experienced use of US allows for the detection of abnormal anatomy or findings (e.g. vein thrombosis) and allows for real-time visualization, which is especially helpful during difficult insertions, absence of landmarks, and in challenging patient groups such as in small infants.