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

Autor: Willis M; Barts Health NHS Trust, London, England., Colonetti E; Department of Clinical and Experimental Sciences University of Brescia, Brescia, Italy., Bakir A; The Ivers Practice, Iver, England., Alame YJ; Hampshire Hospital NHS Foundation Trust, Hampshire, England., Annetts M; Monash Children's Hospital, Melbourne, Australia., Aygin DT; Mid and South Essex NHS Foundation Trust, Chelmsford, England., Daou A; Guy's and St Thomas' NHS Foundation Trust, London, England., Farooq S; Whittington Health NHS Trust, London, England., Fine NA; Barts Health NHS Trust, London, England., Firat G; The Royal Free London NHS Foundation Trust, London, England., Goozee B; St John of God Subiaco Hospital, Perth, Australia., Gupta AN; Dorset County Hospital NHS Foundation Trust, Dorchester, United Kingdom., Hubbett C; Barts Health NHS Trust, London, England., Loi NSY; The Prince Charles Hospital, Brisbane, Australia., Maciejec-Biskup L; Royal North Shore Hospital, Sydney, Australia., Muthukumar MG; Lewisham and Greenwich NHS Foundation Trust, London, England., Pott J; Barts Health NHS Trust, London, England., Bloom BM; Barts Health NHS Trust, London, England., Muiesan ML; Department of Clinical and Experimental Sciences University of Brescia, Brescia, Italy., Harris T; Barts Health NHS Trust, London, England.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Jun 14; Vol. 19 (6), pp. e0305276. Date of Electronic Publication: 2024 Jun 14 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0305276
Abstrakt: Background: Peripheral Intravenous Cannulas (PIVCs) are frequently utilised in the Emergency Department (ED) for delivery of medication and phlebotomy. They are associated with complications and have an associated cost to departmental resources. A growing body of international research suggests many of the PIVCs inserted in the ED are unnecessary.
Methods: The objective of this study was to determine the rates of PIVC insertion and use. This was a prospective observational study conducted in one UK ED and one Italian ED. Adult ED patients with non-immediate triage categories were included over a period of three weeks in the UK ED in August 2016 and two weeks in the Italian ED in March and August 2017. Episodes of PIVC insertion and data on PIVC utilisation in adults were recorded. PIVC use was classified as necessary, unnecessary or unused. The proportion of unnecessary and unused PIVCs was calculated. PIVCs were defined as unnecessary if they were either used for phlebotomy only, or solely for IV fluids in patients that could have potentially been hydrated orally (determined against a priori defined criteria). PIVC classified as unused were not used for any purpose.
Results: A total of 1,618 patients were included amongst which 977 PIVCs were inserted. Of the 977 PIVCs, 413 (42%) were necessary, 536 (55%) were unnecessary, and 28 (3%) were unused. Of the unnecessary PIVCs, 473 (48%) were used solely for phlebotomy and 63 (6%) were used for IV fluids in patients that could drink.
Conclusions: More than half of PIVCs placed in the ED were unnecessary in this study. This suggests that clinical decision making about the benefits and risks of PIVC insertion is not being performed on an individual basis.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Willis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje