Vascular access sonography applies real-time ultrasound guidance to the placement of intravenous access devices, reducing complications and improving first-attempt success rates for central venous catheters, arterial lines, and peripherally inserted central catheters (PICCs). It is a high-impact patient safety application of bedside sonography.
Ultrasound guidance for central line placement — particularly internal jugular and subclavian access — is recommended by multiple clinical guidelines to reduce pneumothorax, arterial puncture, and catheter malposition. Sonographers and proceduralists visualize the target vessel in short-axis and long-axis views, confirm needle tip position, and verify guidewire placement before dilation. Post-placement chest radiograph or intracavitary ECG confirms tip position.
Vascular access sonography is performed by sonographers, nurses, physicians, and advanced practice providers in ICUs, interventional radiology suites, and infusion centers. RDMS and RVT credentials provide the imaging foundation. Many institutions have dedicated PICC teams with ultrasound training, and competency in vascular access guidance is increasingly expected of clinical sonographers working in critical care environments.