Non-dominant hand quicker to insert peripheral venous catheters under echographic guidance: A randomised trial

Background: Ultrasound guidance for venous catheter placement requires the use of both hands. An accurate and stable ultrasound image is fundamental for obtaining good quality images, consequently permitting accurate needle placement. We hypothesized that the dominant hand could be used to perform echography, leaving the non-dominant hand available for peripheral venous catheter (PVC) insertion. Methods: Prospective, open-label, randomized, crossover study. Group 1 inserted the PVC with the dominant hand, and held the probe with the non-dominant hand in a first series of 20 insertions, and vice versa in a second series of 20 insertions performed 11 days later. Group 2 punctured with the non-dominant hand in Series 1 and vice versa in series 2. The study population comprised female student nurses (aged 20-30 years) who had learned neither ultrasound techniques nor catheter insertion. The primary endpoint was time to successful puncture. We recorded age, sex, video game use, and the laterality of hands, feet and eyes. Results: One left-handed and nine right-handed nurses were randomized to each group. Puncture by the non-dominant hand was significantly quicker in both series (P < 0.001). There was no difference between groups for time to successful puncture with the dominant hand; however a significant difference was found for the non-dominant hand (P < 0.01). According to multivariate analysis, the time to successful puncture was significantly lower when the non-dominant hand was used to puncture (adjusted difference 5.6 s, P < 0.0001). Conclusion: Using the dominant hand to hold the ultrasound probe and the non-dominant hand to puncture and insert the catheter achieves successful insertion in a significantly shorter time. (C) 2016 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.