Ultrasound guided IV access offers clearer and more precise needle guidance, ultimately improving patient care.

IV Access Made Easier: How Ultrasound Guidance Can Help

Avery Sinclair in Health & Wellness November 2025 • 5 min read.

"New research validates a rating scale for ultrasound-guided peripheral IV access, paving the way for standardized training and improved patient outcomes."

Starting an IV can be one of the most common, yet surprisingly challenging, procedures in healthcare. Finding a vein, especially in patients with difficult access, can lead to multiple needle sticks, increased patient discomfort, and wasted time. But what if there was a way to improve your success rate and make the process smoother for everyone involved?

Ultrasound guidance is emerging as a game-changer in peripheral intravenous access. By visualizing the veins in real-time, clinicians can target the optimal insertion point, reduce complications, and increase the likelihood of successful catheter placement on the first try. Studies have shown that ultrasound guidance not only improves patient satisfaction but can also decrease the need for central line placements, which carry a higher risk of infection and other complications.

However, the widespread adoption of ultrasound-guided IV access has been hindered by the lack of standardized training and competency assessment. That's where the Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale comes in. This newly validated tool provides an evidence-based standard for evaluating proficiency in ultrasound-guided IV access, ensuring that healthcare professionals have the skills and knowledge to perform the procedure safely and effectively.

The P-UGVA Rating Scale: A New Standard for IV Access Proficiency

Ultrasound guided IV access offers clearer and more precise needle guidance, ultimately improving patient care.

The Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale is designed to assess a healthcare professional's competence in performing ultrasound-guided peripheral IV access. Developed through a rigorous Delphi consensus process involving ultrasound experts, the scale evaluates key elements of the procedure, including:

The rating scale uses a 5-point Likert scale to assess performance in each of these areas, with clear descriptions of what constitutes each level of proficiency. This allows for objective and standardized evaluation, providing valuable feedback to trainees and identifying areas for improvement.

Preparation of utensils: Ensuring all necessary equipment is readily available and properly prepared.
Ergonomics: Maintaining a comfortable and stable working posture for optimal visualization and needle control.
Preparation of the ultrasound device: Selecting the appropriate transducer and optimizing image settings for clear visualization of the target vessel.
Identification of blood vessels: Accurately distinguishing between arteries and veins, and assessing vessel size and depth.
Anatomy: Recognizing relevant anatomical structures and selecting the most suitable puncture site.
Hygiene: Adhering to strict hygiene protocols to minimize the risk of infection.
Coordination of the needle: Precisely controlling the needle tip and navigating it to the target vessel.
Completion of the procedure: Successfully inserting the catheter and ensuring proper placement within the vein.

In a recent study, researchers explored the validity of the P-UGVA rating scale by evaluating the performance of physicians with varying levels of experience (novices, intermediates, and experts) in ultrasound-guided IV access. The results showed that the P-UGVA rating scale effectively discriminated between the different proficiency groups, with experts consistently scoring higher than novices and intermediates. The scale also demonstrated strong correlation with overall performance evaluations, indicating that it accurately reflects a clinician's true skill level.

The Future of IV Access: Standardized Training and Improved Patient Care

The validation of the P-UGVA rating scale represents a significant step forward in the field of vascular access. By providing a standardized and objective measure of competence, the scale can be used to:

Ultimately, the widespread adoption of ultrasound-guided IV access and the implementation of standardized training programs will lead to improved patient outcomes, reduced complications, and increased efficiency in healthcare settings. The P-UGVA rating scale is a valuable tool for achieving these goals.

While the P-UGVA offers a promising standard, further research is needed to explore its long-term impact on clinical practice and patient outcomes. Studies should also investigate the optimal number of assessments needed for reliable competency evaluation and the cost-effectiveness of implementing ultrasound-guided IV access programs.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1097/md.0000000000009576, Alternate LINK

Title: Validation Of The Peripheral Ultrasound-Guided Vascular Access Rating Scale

Subject: General Medicine

Journal: Medicine

Publisher: Ovid Technologies (Wolters Kluwer Health)

Authors: Stine C. Primdahl, Jesper Weile, Louise Clemmesen, Kristian R. Madsen, Yousif Subhi, Poul Petersen, Ole Graumann

Published: 2018-01-01

Everything You Need To Know

How does ultrasound guidance improve the success rate of starting an IV?

Ultrasound guidance enhances peripheral intravenous access by allowing clinicians to visualize veins in real-time. This precision leads to more accurate targeting of the optimal insertion point. This process reduces complications, increases first-attempt success rates and decreases the need for central lines, which pose a higher risk of infection. While the text highlights ultrasound guidance, other methods like vein finders or transillumination are also used to locate veins, but ultrasound offers a direct visual.

What specific elements of IV access does the Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale evaluate?

The Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale assesses competence in performing ultrasound-guided peripheral IV access. It evaluates key elements such as preparation of utensils, ergonomics, preparation of the ultrasound device, identification of blood vessels, anatomy, hygiene, coordination of the needle, and completion of the procedure. The P-UGVA Rating Scale uses a 5-point Likert scale to assess the performance in each of these areas.

How does the Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale standardize the evaluation of IV access skills?

The Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale uses a 5-point Likert scale to evaluate proficiency in key areas of ultrasound-guided IV access. This allows for an objective and standardized assessment of a healthcare professional's skills, providing valuable feedback for trainees and highlighting areas needing improvement. The scale looks at aspects like preparation, ergonomics, vessel identification, and needle coordination to ensure competency.

What are the broader implications of validating the Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale for patient care and healthcare training?

The validation of the Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale signifies a move towards standardized training and assessment in vascular access. It offers an objective measure of competence, facilitating the development of targeted training programs, reducing variability in practice, and ultimately improving patient care by ensuring healthcare professionals are adequately skilled in ultrasound-guided IV access. This could lead to reduced complications and improved success rates.

In what way does the Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale contribute to the standardization of training for ultrasound-guided IV access?

The Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale helps standardize training in ultrasound-guided IV access by providing a structured framework for evaluating proficiency. By assessing key elements of the procedure, the scale allows trainers to identify specific areas where healthcare professionals need additional support and guidance. Standardized training ensures consistent skill levels and reduces the risk of complications associated with poorly performed IV placements. However, the effectiveness of training also depends on the availability of resources, experienced instructors, and ongoing support.