Half of All Peripheral Intravenous Lines in an Australian Tertiary Emergency Department Are Unused: Pain With No Gain?

Limm, Ezra I.; Fang, Xin; Dendle, Claire; Stuart, Rhonda L.; Egerton-Warburton, Diana

doi:10.1016/j.annemergmed.2013.02.022

Cited by 87 publications

(101 citation statements)

References 9 publications

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“…This is in contrast to existing literature. [9][10][11] Our study identified that the vast majority of PIVCs inserted were used, which stands in contrast to existing literature. Previous ED studies have identified that between 47 to 56% of PIVCs are unused.…”

Section: Discussioncontrasting

confidence: 60%

“…Previous ED studies have identified that between 47 to 56% of PIVCs are unused. [9][10][11] For example, in the USA Nguyen et al 10 reported 47% (n=12,475) of PIVCs inserted in two USA EDs remained unused. However, the study was undertaken in a Paediatric ED and the authors go on to state that clinicians tend to treat younger patients more conservatively.…”

Section: Discussionmentioning

confidence: 99%

“…One Australian tertiary referral ED study conducted by Limm et al 15 reported that 50% of PIVCs inserted remained unused. While this study's demographics and characteristics were similar to the current study the findings of PIVC utility were very different with a greater percentage of cannuale used for medical interventions.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10] A recent Australian ED study identified that fifty percent of intravenous cannulae inserted were unused or unwarranted. 11 Similarly, a study conducted by Henderson et al 9 identified that when PIVC access was initiated in the ED, only 42.2% (ambulance patients) and 48% (self-presenting patients) respectively had their PIVCs used. They also identified that 71.3% of the unused PIVCs in the ED were used only for pathology specimen acquisition.…”

Section: Introductionmentioning

confidence: 99%

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Utility of peripheral intravenous cannulae inserted in one tertiary referral emergency department: A medical record audit

Fry

Romero

Berry

2016

Australasian Emergency Nursing Journal

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Introduction:Peripheral intravenous cannulation is a common intervention performed within the Emergency Department by medical staff to assist in the delivery of care. However, previous studies have shown Emergency Department patients that have cannula device inserted are often not used. Across Australia, it is unclear the utility and frequency of use of peripheral intravenous cannulae within the emergency setting. Method: This is a random retrospective cohort study. Clinical information was retrieved from the Emergency Department Database, FirstNet and the paper medical record. Data from FirstNet included: patient demographic (age, gender) and clinical information (time of arrival, triage category, presenting problem, discharge diagnostic code, and disposition). Data from the patient medical record included: demographic (age, gender) and clinical information (Cannula usage and time of fluids, pharmacological agents, complications, pathology radiological investigations, other diagnostic uses). Results: Of the 357 randomised patients, 189 (52.9%) had 209 peripheral intravenous cannula inserted. Of these cannulae 186 (88.9%) were used within 72 hours. The majority of cannulae (70.4%; n=131) had more than one medical intervention. Conclusion:The majority of peripheral intravenous cannulae inserted during the Emergency Department visit were subsequently used for medical treatment. Further, the majority of devices were used for intravenous fluids and or medications and accessed for multiple interventions. For future audit purposes improved documentation of this procedure is needed.

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Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Utility of peripheral intravenous cannulae inserted in one tertiary referral emergency department: A medical record audit

Fry

Romero

Berry

2016

Australasian Emergency Nursing Journal

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“…2 The large majority of patients with an otherwise unused PIVC in the Limm et al study had blood drawn for pathology tests. 1 Authors have challenged the usefulness of many pathology tests ordered in the ED, suggesting that they do not all contribute to patient care, and add unproductive costs. 5 This phenomenon could be described as the 'heroic search for abnormal test results'.…”

mentioning

confidence: 99%

First do no harm: In fact, first do nothing, at least not a cannula

Egerton-Warburton

Ieraci

2013

Emerg Medicine Australasia

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Analysis of a Commercial Insurance Policy to Deny Coverage for Emergency Department Visits With Nonemergent Diagnoses

et al. 2018

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Key Points Question If commercial insurers retrospectively deny coverage for emergency department (ED) visits based on diagnoses determined to be nonemergent, what visits will be denied coverage? Findings This cross-sectional study found that 1 insurer’s list of nonemergent diagnoses would classify 15.7% of commercially insured adult ED visits for possible coverage denial. However, these visits shared the same presenting symptoms as 87.9% of ED visits, of which 65.1% received emergency-level services. Meaning A retrospective diagnosis-based policy is not associated with accurate identification of unnecessary ED visits and could put many commercially insured patients at risk of coverage denial.

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Half of All Peripheral Intravenous Lines in an Australian Tertiary Emergency Department Are Unused: Pain With No Gain?

Cited by 87 publications

References 9 publications

Utility of peripheral intravenous cannulae inserted in one tertiary referral emergency department: A medical record audit

Utility of peripheral intravenous cannulae inserted in one tertiary referral emergency department: A medical record audit

First do no harm: In fact, first do nothing, at least not a cannula

Analysis of a Commercial Insurance Policy to Deny Coverage for Emergency Department Visits With Nonemergent Diagnoses

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