Fat children, women with thick arms, critically ill patients with high edema, elderly people who have been repeatedly punctured for a long time, and patients undergoing chemotherapy for cancer often give nurses a headache because the blood vessels are “invisible and inaccessible”, resulting in painful repeated punctures and increased costs, and in severe cases, drug leakage and tissue necrosis, interrupting treatment, or even In other cases, drug leakage and tissue necrosis may interrupt treatment, and even delay the resuscitation of critically ill patients. In response to this situation, our hospital introduced a site-Rite5 vascular ultrasound instrument specifically for vascular puncture, the instrument can clearly display 0-6cm tissue, ultrasound probe is also equipped with a special needle guide installation facilities, puncture as long as the probe on the needle guide, the puncture needle into the needle guide on the needle slot, can be very accurate puncture to the vessel. Since its introduction in early 2012, the instrument has been used to successfully puncture and insert PICC catheters for more than 300 patients in more than 30 departments throughout the hospital, solving a difficult problem in clinical infusion treatment. The youngest of the 300 patients is only 1 year old and the oldest is 104 years old. Shuang Shuang, a child in the burn unit, was burned on the head, neck, both upper limbs and torso, with 43% of the burn area, so it was very difficult to puncture and infuse. The PICC catheter was successfully placed in the operating room by nurse managers Gao Zhulin and Peng Yongzhi, which established an effective ground vein access that could be preserved for a longer period of time and completed all the later treatment tasks. Han had been hospitalized in Ward 14 for more than three years, and he needed long-term intravenous infusion treatment because of the sequelae of cerebral hemorrhage, Alzheimer’s disease, diabetes and other diseases. After the introduction of the vascular ultrasound machine, they were the first to apply. Although the patient’s whole body could not see a suitable blood vessel under the naked eye, the blood vessel was clearly visible under ultrasound, and soon a PICC catheter was successfully placed into the precious vein of Han’s upper arm. Over the past six months, ultrasound guidance combined with Seidinger’s puncture method has successfully punctured and placed more than 80 cases for elderly people over 75 years old, making it one of the indispensable tools for intravenous infusion in elderly patients. Traditional peripheral puncture placement of central venous catheter (PICC) has certain advantages over CVC (central venous catheter via internal jugular vein, subclavian vein and femoral vein) due to its simplicity, safety and ease of maintenance, and the PICC catheter with frontal opening can also be used for central venous pressure monitoring. Critical patients are often infused with large amounts of fluids, long infusion time, coupled with swelling of the extremities due to the condition, blind penetration difficulties can be imagined, vascular ultrasound instrument can not only clearly distinguish the vessels and surrounding tissues, but also through the specially matched needle guide according to the depth of the vessel from the skin, choose a different needle degree very accurate positioning to ensure successful puncture. PICC placement using vascular ultrasound instrument has the following features compared with traditional PICC placement: 1. 2.Changing from elbow puncture to above-elbow puncture, avoiding the lack of catheter movement due to elbow activity, reducing the occurrence of catheter infection and mechanical phlebitis. 3.Improved the quality of life of patients, the puncture point on the elbow does not affect the patient’s joint movement and is more concealed. Nowadays, professional nurses, ultrasound guidance + Seidinger puncture and upper arm placement have become the gold standard for PICC placement.