Improving peripheral intravenous cannula insertion techniques

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Abstract:

Background: We sought to identify the reasons for peripheral intravenous cannulae insertion in the emergency department (ED), and the first-time insertion success rate, along with patient and clinician factors influencing this phenomenon.

Methods: A prospective cohort study of patients requiring peripheral cannulae insertion in a tertiary ED. Clinical and clinician data were obtained.

Results: A total 734 peripheral intravenous cannula (PIVC) insertions were included in the study where 460 insertions were analysed. The first-time insertion success incidence was 86%. The antecubital fossa (ACF) site accounted for over 50% of insertions. Multivariate logistic regression modelling to predict first-time insertion success for patient factors found: age

Conclusions: Peripheral intravenous cannulation insertion success could be improved if performed by clinicians with greater procedural experience and increased perception of the likelihood of success. Some patient factors predict cannulation success: ‘normal’ body weight, visible vein/s and cubital fossa placement; venepuncture may be a cheaper alternative for others if intravenous therapy is not imperative.

Reference:

Carr, P.J., Rippey, J.C.R., Budgeon, C.A., Cooke, M.L., Higgins, N. and Rickard, C.M. (2015) Insertion of peripheral intravenous cannulae in the Emergency Department: factors associated with first-time insertion success. The Journal of Vascular Access. December 4th. [epub ahead of print].

DOI:10.5301/jva.5000487

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