Prospective observational study of peripheral intravenous cannula utilisation and frequency of intravenous fluid delivery in the emergency department: convenience or necessity?

Introduction

Over one billion peripheral intravenous cannulas (PIVCs) are inserted worldwide each year. Insertion of PIVCs is associated with pain, phlebitis, occlusion, and medication extravasation as well as the risk of catheter-associated infection, with an associated cost to departmental resources. Previous studies have not assessed if intravenous (IV) fluid delivery followed best practice or was required for the clinical situation. Insertion of PIVCs may alter clinician prescribing behaviour, potentially influencing the prescribing of IV fluids where oral hydration could be used. Data suggests that supplementary IV fluids are not always required. Identifying the incidence of unnecessary IV fluid delivery could assist in guiding policy concerning the insertion and appropriate usage of PIVCs. Here we present the results of a prospective observational study to determine the rates of PIVC insertion and use in two urban emergency departments (EDs).

Methods

This was a prospective observational study conducted in one UK ED (centre A) and one Italian ED (centre B). Adult ED patients with non-immediate triage categories were included over three weeks in centre A in August 2016 and two weeks in centre B in March and August 2017. Data was collected on the insertion and utilisation of PIVCs. PIVC use was classified as necessary, unnecessary,

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