Comparison of Elastic Tourniquet and Blood Pressure Cuff for Peripheral Intravenous Access in Hypotensive Patients: A Randomized Single-Blind Study.

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-09-01 Epub Date: 2025-07-08 DOI:10.1016/j.jemermed.2025.07.004

İlker Şirin, Şerife Büşra Uysal, Afşin Emre Kayıpmaz

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引用次数: 0

Abstract

Background: Peripheral intravenous catheterization (PIVC) is one of the most common invasive procedures performed in emergency departments (EDs). Elastic tourniquets (ET) and blood pressure cuffs (BPC) are most commonly used for venodilatation. Difficult vascular access can be predicted in some patients, and the rate of successful first-time PIVC placement in this group is low.

Objective: In this study, we investigated which venodilatation method is most appropriate for hypotensive patients, a group in whom vascular access is predicted to be difficult.

Methods: This was a prospective, single-blind, randomized controlled trial in the ED of a tertiary care hospital. Hypotensive patients were randomly assigned to two methods of administration. Patients' basilic vein diameters and venous collapsibility were measured before and after the intervention by a physician blinded to the intervention, followed by intravenous (IV) access. The primary outcome was the change in basilic vein diameter after the applied venodilatation method (ET or BPC), and the secondary outcomes were the change in vein collapsibility and initial access success rate.

Results: In this study of 101 patients, basilic vein diameter increased from 4.05 to 5.4 mm in the BPC group and from 4.1 to 4.5 mm in the ET group. The change in diameter in the BPC group was greater than that in the ET group (p < .0001). In addition, IV access was successful in 33 (63%) of 52 patients in the BPC group on the first attempt and in 20 (41%) of 49 patients in the ET group. The change in collapsibility was greater in the BPC group after the procedure.

Conclusion: BPC during PIVC insertion in hypotensive patients presenting to the ED showed both a greater increase in basilic vein diameter and superior initial access success than ET. Therefore, we recommend BPC as a method of venodilatation in hypotensive patients.

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弹性止血带和血压袖带用于低血压患者外周静脉注射的比较：一项随机单盲研究。

目的：外周静脉导管（PIVC）是急诊科（EDs）最常见的侵入性手术之一。弹性止血带（ET）和血压袖带（BPC）最常用于静脉扩张。在一些患者中可以预测血管通路困难，并且该组首次PIVC放置的成功率很低。在这项研究中，我们调查了哪种静脉扩张方法最适合低血压患者，这一组患者的血管通路预计是困难的。方法：这是一项前瞻性、单盲、随机对照试验，在三级护理医院的急诊科进行。低血压患者随机分配两种给药方法。由一名不知情的医生在干预前后测量患者的基底静脉直径和静脉溃散性，然后进行静脉（IV）注射。主要观察指标为应用静脉扩张法（ET或BPC）后基底静脉内径的变化，次要观察指标为静脉溃散性和初始通路成功率的变化。结果：101例患者中，BPC组的基底静脉直径从4.05 mm增加到5.4 mm， ET组的基底静脉直径从4.1 mm增加到4.5 mm。BPC组的直径变化大于ET组（p < 0.0001）。此外，52例BPC组患者中有33例（63%）在第一次尝试时静脉滴注成功，49例ET组中有20例（41%）静脉滴注成功。术后BPC组可折叠性变化更大。结论：在出现ED的低血压患者中，在PIVC插入期间BPC比ET有更大的basil静脉直径增加和更高的初始通路成功率。因此，我们推荐BPC作为低血压患者的静脉扩张方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine