Background:  Patients with difficult intravenous access represent a contextual problem of emergency medicine setting. The spreading of ultrasound and the increasing fragility of the in-hospital population led to find new approaches of peripheral venous catheterization, trying  to avoid invasive, expensive, time-consuming and prone to serious adverse events procedure, such as central venous catheterization. JLB®  (Deltamed Inc) is an over the needle catheter designed for large peripheral veins, such as Internal Jugular vein (IJV). Its hyperecoic tip enables to perform easily an eco-guided bedside non-sterile (aseptic) technique. Materials and Methods: JLB®  was distributed to 3 Emergency Medicine wards, 2  Anesthesiology and 1 Internal Medicine ward. A retrospective observational multicentric study was conducted from July 2015 to April 2016. The device was inserted using a high frequency linear probe. Data have been collected referring to demographics, device specifications (available in 80/70/60 mm length,14/16/17/18 Gauge diameter), procedure times and complications. Results: Preliminary data refer to 214 cases of 400 enrolled. Mean age 72.9 years ± 16, SD; 121 women. Main indication for cannulation with JLB®  were peripheral venous pool depletion and need of inotropes. Positioning site: IJV (90,6%), Basilic/Cephalic (8,9%). No major adverse events (iatrogenic pneumothorax, arterial cannulation, thrombosis, major arrhythmia and devices related infection); 3 minor complications (soft tissues haematoma, atrial fibrillation, self-removal); Indications to removal: no more requirement and death. Mean procedure time: <4min. Success at first attempt of cannulation: 77.5%. Conclusion: Actually JLB®  results safe and improves patient management and costs, especially when alternative techniques could be an overtreatment.

New approaches in peripheral venous catheterization: JLB®, a new catheter for large veins