References

Gledstone-Brown L, McHugh D. Review article: Idle ‘just-in-case’ peripheral intravenous cannulas in the emergency department: is something wrong?. Emerg Med Australas. 2018; 30:(3)309-326 https://doi.org/10.1111/1742-6723.12877

Hallam C, Denton A. Vessel health and preservation 1: minimising the risks of vascular access. Nursing Times online. 2020; 116:(7)22-25

Hawkins T, Greenslade JH, Suna J Peripheral intravenous cannula insertion and use in the emergency department: an intervention study. Acad Emerg Med. 2018; 25:(1)26-32 https://doi.org/10.1111/acem.13335

Thomas C, Cabilan CJ, Johnston ANB. Peripheral intravenous cannula insertion and use in a tertiary hospital emergency department: a cross-sectional study. Australas Emerg Care. 2020; 23:(3)166-172 https://doi.org/10.1016/j.auec.2020.02.001

Can ‘just in case’ PIVC placement still be justified?

28 October 2021
2 min read
Volume 30 · Issue 19

Emergency departments (EDs) have recently been experiencing an unprecedented surge in activity while our health economy resettles after the COVID-19 pandemic waves. This has led us to have to quickly rationalise and reframe how we provide our emergency care.

We know that peripheral IV cannulation (PIVC) is one of the most commonly performed invasive procedures in the ED. We also know that up to 40% of all PIVCs placed are not used or are used for only a secondary purpose, such as collection of blood samples (Thomas et al, 2020). IV access specialists have long advocated that IV access devices should only be placed if IV therapy is definitely required.

The first question of the Vessel Health Preservation Framework is whether there is a ‘genuine need for vascular access’ (Hallam, 2020). PIVC insertion can be painful for patients and comes with risks such as infection, bleeding and thrombosis. From an organisational perspective, it also adds cost and clinician time, both of which, in today's health economy, need to be carefully rationalised. So is it now time to actively challenge the notion of providing IV access ‘just in case’?

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