Letters
Emergency medicine Infectious diseases
Volume 199 - Issue 10

Think before you insert an intravenous catheter

Authors:  Claire Dendle, Rhonda L Stuart and Diana Egerton-Warburton

Med J Aust 2013; 199 (10): 655. || doi: 10.5694/mja13.10733
Published online: 18 November 2013
Clinicians should sometimes just say no to the “just in case” peripheral intravenous catheter to reduce harm caused.
Download PDF (146 KB)
Share: Share on Blue Sky Share on Facebook Share on LinkedIn Share by email

To the Editor: Peripheral intravenous catheter (PIVC) infection has been highlighted by one of us (R L S) and colleagues as an important, costly and dangerous complication of PIVCs.1 Infection prevention programs often employ multifaceted interventions and, in the case of PIVC, much debate has been directed towards aseptic insertion and appropriate dwell times, but little attention has been directed to whether the PIVC is required.2

The concept of the “idle IV” catheter was introduced over 20 years ago,3 yet at our tertiary hospital emergency department (ED), we found that half of PIVCs inserted were unused. In 43% of patients admitted to the hospital, the PIVC remained unused at 72 hours.4 Patients presenting with obstetric, gynaecological and neurological symptoms were significantly more likely to have an unused PIVC.4

Focus group testing revealed that it had become a culture within our ED to insert a PIVC in most patients “just in case”. We have started a program encouraging staff to think before they insert an IV catheter, and to “just say no to the ‘just in case’ PIVC”. Our study did not examine harm caused by unused PIVCs, but the potential benefits of such a program include reduction in infections, phlebitis, patient discomfort and financial cost (24 cents for venepuncture compared with $4.37 for PIVC equipment).1

To address the potentially preventable, iatrogenic complication of infected PIVCs, a sometimes-neglected point of intervention is for clinicians to decide whether the PIVC is actually required in the first place.

Authors

  • Claire Dendle1
  • Rhonda L Stuart2
  • Diana Egerton-Warburton2
  • 1. Department of Infectious Diseases, Southern Health, Melbourne, VIC.
  • 2. Monash Health, Monash University, Melbourne, VIC.

Correspondence: claire.dendle@monash.edu

Competing interests

No relevant disclosures.

References

View this article on Wiley Online Library

More like this

View more