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However, a proportion of physicians still continue to perform landmark techniques and consider this technique as an alternative to US.
Several studies have demonstrated that ultrasound can be used to successfully place peripheral IVs in patients who have failed landmark techniques [1, 3 6].
Although ultrasound (US) guidance has been recommended to aid insertion, its use is far from established practice and landmark techniques and the TOS is still widely practiced.
Prior to ultrasound-guided peripheral intravenous access (USGPIV), patients with failed landmark techniques often required central venous cannulation, a procedure with a higher complication rate and demanding more staff resources than peripheral access [2, 7].
Landmark techniques for obtaining peripheral IV access are usually successful, but patients with prior IV drug abuse, obesity, and chronic medical conditions are more likely to have failed attempts [1, 2].
While USGPIV has a high success rate among patients who have failed landmark techniques, several studies have shown that vein size is an important predictor of successful ultrasound-guided vascular access [1, 3 6].
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No study has ever demonstrated the superiority of landmark technique over the US-guided technique.
Placement of the central line was successful with landmark technique, and there were no sequelae.
It is usually achieved with a blinded, external landmark technique or by vein denudation.
With our landmark technique, transverse fracture rotations can be measured more easily.
Finally, 91 % think that the landmark technique should still be taught to the residents.
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