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

被引：1

作者：

Willis, Michael ^{[1
]}

Colonetti, Efrem ^{[2
]}

Bakir, Ali ^{[3
]}

Alame, Yousef Jamal ^{[4
]}

Annetts, Megan ^{[5
]}

Aygin, Deren T. ^{[6
]}

Daou, Amina ^{[7
]}

Farooq, Sultan ^{[8
]}

Fine, Nicholas A. ^{[1
]}

Firat, Gozde ^{[9
]}

Goozee, Benjamin ^{[10
]}

Gupta, Anuj Neelesh ^{[11
]}

Hubbett, Charlotte ^{[1
]}

Loi, Nicole Shun Yee ^{[12
]}

Maciejec-Biskup, Laura ^{[13
]}

Muthukumar, Merline Gabriela ^{[14
]}

Pott, Jason ^{[1
]}

Bloom, Benjamin M. ^{[1
]}

Muiesan, Maria Lorenza ^{[2
]}

Harris, Tim ^{[1
]}

机构：

[1] Barts Hlth NHS Trust, London, England

[2] Univ Brescia, Dept Clin & Expt Sci, Brescia, Italy

[3] Ivers Practice, Iver, England

[4] Hampshire Hosp NHS Fdn Trust, Basingstoke, Hants, England

[5] Monash Childrens Hosp, Melbourne, Australia

[6] Mid & South Essex NHS Fdn Trust, Chelmsford, England

[7] Guys & St ThomasNHS Fdn Trust, London, England

[8] Whittington Hlth NHS Trust, London, England

[9] Royal Free London NHS Fdn Trust, London, England

[10] St John God Subiaco Hosp, Perth, Australia

[11] Dorset Cty Hosp NHS Fdn Trust, Dorchester, England

[12] Prince Charles Hosp, Brisbane, Australia

[13] Royal North Shore Hosp, Sydney, Australia

[14] Lewisham & Greenwich NHS Fdn Trust, London, England

来源：

PLOS ONE | 2024年 / 19卷 / 06期

关键词：

VENOUS CATHETERS; COMPLICATIONS; PLACEMENT; INSERTION; CHLORIDE; RISK;

D O I：

10.1371/journal.pone.0305276

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

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.

引用

页数：10

共 27 条

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