Prehospital use of peripheral intravenous catheters and intraosseous devices: An integrative literature review of current practices and issues

Mason, Matthew; Wallis, Marianne; Lord, Bill; Barr, Nigel

doi:10.1016/j.auec.2020.06.004

Cited by 13 publications

(15 citation statements)

References 48 publications

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“…As such we deemed any idle PIVC in our study as an inappropriate insertion. A recent systematic review highlighted the lack of literature surrounding the rate of idle PIVCs in the prehospital setting (21) . Our study is the rst study to directly compare idle rates of PIVC between prehospital and ED settings.…”

Section: Discussionmentioning

confidence: 99%

“…Paramedics are an important group of providers who are skilled in PIVC insertion and are commonly the rst point of healthcare contact for the patient. Sparse knowledge of PIVC insertion practices in the prehospital environment exists (21) .…”

Section: Introductionmentioning

confidence: 99%

“…This may have an effect on the proportion of idle PIVC compared to ED insertion. The lack of literature regarding rates of idle PIVC, especially in the pre-hospital setting has been highlighted previously (21) .…”

Section: Introductionmentioning

confidence: 99%

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WITHDRAWN: Idle peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices

Evison

Sweeny²,

Ranse

et al. 2020

Preprint

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Background Unused ('idle') peripheral intravenous catheters (PIVC) are those not used within 24 hours of insertion. There is little data on cannulation practices and idle PIVC rates in emergency settings, especially the pre-hospital environment. Methods This was an observational cohort study set in south-east Queensland, Australia using data from a large tertiary level emergency department (ED) and the local statutory ambulance service. Demographic, clinical and PIVC data were collected over two periods; 9 February - 18 March 2017 and 5 January - 4 February 2018. Adult patients were included if they were allocated an Australasian triage scale (ATS) category between 2 and 5, and had a PIVC inserted in the pre-hospital setting or ED. PIVC use was defined as idle if no fluids, medications or contrast were administered intravenously within 24 hours of insertion. Comparisons between pre-hospital and ED practice and idle PIVC status were undertaken using descriptive statistics and logistic regression.Results A total of 1249 patients with a PIVC (372 pre-hospital; 877 ED) were included. Overall, 366 PIVCs (29.3%; 95% CI 26.9%-31.9%) remained idle at 24h. In the pre-hospital group, 147 (39.5%) PIVCs inserted were not used pre-hospital, and 74 (19.9%) remained idle. In comparison, 292 (33.3%) PIVCs placed in the ED remained idle. ED staff more frequently inserted PIVCs in the antecubital fossa than paramedics (65.5% vs 49.7%), where forearm PIVC insertion was more common pre-hospital than in ED (13.7% vs 7.4%). Nursing staff inserted idle PIVC at a rate of (35.1%) compared to doctors (29.6%) and paramedics (19.9%). Having a PIVC insertion in the ED was the only factor significantly (p=<.001) predicting an idle outcome (Odds Ratio: 2.4; 95%CI 1.7-3.3). Conclusion One-third of PIVCs inserted within the emergency setting remained idle, suggesting unnecessary risk and costs. Pre-hospital and ED PIVC insertion practices differed, with idle PIVCs 2.4 times more prevalent if inserted in the ED than pre-hospital and with greater use of ante-cubital insertion. Reasons for these differences are not well understood and requires more targeted research.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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WITHDRAWN: Idle peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices

Evison

Sweeny²,

Ranse

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Paramedics are an important group of providers who are skilled in PIVC insertion and are commonly the first point of healthcare contact for the patient. Sparse knowledge of PIVC insertion practices in the pre-hospital environment exists [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…This may have an effect on the proportion of idle PIVCs compared to ED insertion. The lack of literature regarding rates of idle PIVCs, especially in the pre-hospital setting has been highlighted previously [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Idle peripheral intravenous cannulation: an observational cohort study of pre-hospital and emergency department practices

Evison¹,

Sweeny

Ranse

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background Unused ('idle') peripheral intravenous catheters (PIVC) are those not used within 24 hours of insertion. There is little data on cannulation practices and idle PIVC rates in emergency settings, especially the pre-hospital environment. Methods This was an observational cohort study set in south-east Queensland, Australia using data from a large tertiary level emergency department (ED) and the local statutory ambulance service. Demographic, clinical and PIVC data were collected over two periods; 9 February–18 March 2017 and 5 January–4 February 2018. Adult patients were included if they were allocated an Australasian triage scale (ATS) category between 2 and 5, and had a PIVC inserted in the pre-hospital setting or ED. PIVC use was defined as idle if no fluids, medications or contrast were administered intravenously within 24 hours of insertion. Comparisons between pre-hospital and ED practice and idle PIVC status were undertaken using descriptive statistics and logistic regression. Results A total of 1249 patients with a PIVC (372 pre-hospital; 877 ED) were included. Overall, 366 PIVCs (29.3%; 95% CI 26.9%–31.9%) remained idle at 24 hours. In the pre-hospital group, 147 (39.5%) PIVCs inserted were not used pre-hospital, and 74 (19.9%) remained idle. In comparison, 292 (33.3%) PIVCs placed in the ED remained idle. ED staff more frequently inserted PIVCs in the antecubital fossa than paramedics (65.5% vs. 49.7%), where forearm PIVC insertion was more common pre-hospital than in ED (13.7% vs. 7.4%). Nursing staff inserted idle PIVCs at a rate of (35.1%) compared to doctors (29.6%) and paramedics (19.9%). Having a PIVC inserted in the ED was the only factor significantly (p ≤ .001) predicting an idle outcome (Odds Ratio: 2.4; 95% CI 1.7–3.3). Conclusion One-third of PIVCs inserted within the emergency setting remained idle, suggesting unnecessary risk and costs. Pre-hospital and ED PIVC insertion practices differed, with idle PIVCs 2.4 times more prevalent if inserted in the ED than pre-hospital and with greater use of antecubital insertion. Reasons for these differences are not well understood and requires more targeted research.

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Recent Advances in Intraosseous Vascular Access

Szydlowski

Nolte²,

Vershilovsky³

2021

Curr Emerg Hosp Med Rep

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Prehospital use of peripheral intravenous catheters and intraosseous devices: An integrative literature review of current practices and issues

Cited by 13 publications

References 48 publications

WITHDRAWN: Idle peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices

WITHDRAWN: Idle peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices

Idle peripheral intravenous cannulation: an observational cohort study of pre-hospital and emergency department practices

Recent Advances in Intraosseous Vascular Access

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Prehospital use of peripheral intravenous catheters and intraosseous devices: An integrative literature review of current practices and issues

Cited by 13 publications

References 48 publications

WITHDRAWN: Idle&nbsp;peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices

WITHDRAWN: Idle&nbsp;peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices

Idle peripheral intravenous cannulation: an observational cohort study of pre-hospital and emergency department practices

Recent Advances in Intraosseous Vascular Access

Contact Info

Product

Resources

About

WITHDRAWN: Idle peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices

WITHDRAWN: Idle peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices