Ultrasound use for vascular access is being used more frequently for insertion of several vascular access devices. Using ultrasound for vein access in “difficult” patients can decrease the number of attempts and anxiety for our patients. We have a team of nurses who have learned this technique and teach this procedure to other health care professionals in ED, ICU and on the Med/Surg units. In our ED physicians are working with the nurse to place devices using ultrasound. A team approach to vascular access increase success rates and decreases patients anxiety and fears with the insertion of the device. Nurses in our facility use ultrasound for PIV, Midline and PICC line insertion. Use the ultrasound on patients with good veins. Explain the procedure to the patient visualize and palpate good veins. Once you become competent in this skill, you will become the expert that your colleagues will call upon.