Episode 335: Ultrasound-Guided IV Placement in the Oncology Setting

“Much like many experienced oncology nurses, I learned how to do IVs with palpation. I got really good at it. And so I thought, there’s no way I need this ultrasound. But we know now that our patients are sicker. There are more DIVA patients, or difficult IV access patients. We’ve got to put the patient first, and we’ve got to use the best technology. So I’ve really come full circle with my thinking. In fact, now it’s like driving a car without a seatbelt,” MiKaela Olsen, DNP, APRN-CNS, AOCNS®, FAAN, clinical program director of oncology at Johns Hopkins Hospital and Johns Hopkins Health System told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about ultrasound-guided IV placement.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by November 1, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: The learner will report an increase in knowledge related to ultrasound-guided peripheral IV placement in the oncology setting.

Episode Notes 

• Complete this evaluation for free NCPD. 
• Oncology Nursing Podcast™ episodes: Episode 127: Reduce and Manage Extravasation When Administering Antineoplastic Agents
• ONS Voice articles:
  • Access Devices and Central Lines: New Evidence and Innovations Are Changing Practice, but Individual Patient Needs Always Come First
  • Standardizing Venous Access Assessment and Validating Safe Chemo Administration Drastically Lowers Rates of Adverse Venous Events
• ONS book: Access Device Guidelines: Recommendations for Nursing Practice and Education (Fourth Edition)
• ONS courses:
  • Complications of Vascular Access Devices (VAD) and Intravenous (IV) Therapy
  • Vascular Access Devices
• Clinical Journal of Oncology Nursing article: Standardized Venous Access Assessment and Safe Chemotherapy Administration to Reduce Adverse Venous Events
• StatPearls Video: Forearm Anatomy Review and Ultrasound Probing
• Infusion Nurses Society: Infusion Therapy Standards of Practice (Ninth Edition)

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an Oncology Nursing Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“The benefit of having an ultrasound, it allows you to see through. You’re no longer sort of bound by, ‘Can I feel it? Are there skin discolorations or skin colors that are affecting my ability to see the vein clearly?’ You don’t have to worry about any of that. Is there edema? Is there lots of tissue? You can actually directly visualize the veins to assess not only the health of the vein, but some of the complications that could be there, like a thrombus in the vein or sclerosis or tortuous anatomy, arteries, nerve bundles. Those are things that you can now see with your machine.” TS 8:55

“I think that the most important part of [training] is having a really good didactic session where nurses come in and they learn reminders about the anatomy. Where are these veins? Where are the best veins to canulate when you’re using ultrasound? And we like to avoid the veins above the antecube for regular long peripheral IVs that we insert with ultrasound because we want to preserve those veins up higher for our [peripherally inserted central catheter] lines and midline. So we want to teach to try to use the forearm. The cephalic vein in the forearm is a really excellent vein to choose.” TS 17:24

“[Patients] are usually kind of impressed with the machine and the technology, and I explain that ‘We’re not able to get it without being able to see better, so I’m going to use my machine so that I can see better.’ And almost every time after I’m done, the patient is like, ‘Wow, are you done?’ … It’s the initial little puncture that hurts the patient. But unlike when we do it blindly and maybe we don’t get it right in the vein, and we’re having to dig around and reposition ourselves and get into that vein, we’re not doing that with ultrasound because you’re going to go into the vein, and then you're starting to do the threading, and you’re pulling your probe up as you go to get that catheter in the vein. The patient doesn’t feel that part. So they often comment about how they barely felt it and they can’t believe it’s over.” TS 21:21

“This is kind of my measure of success when we’re no longer kind of putting this on the patient. We’re not saying, ‘You have difficult veins. Your veins roll. You’re not drinking enough.’ That’s not okay anymore. We’ve got to take responsibility and use technology to do this more successfully.” TS 30:24