Tag Archive for: Peripheral IV

Should We Use Skin Glue to Secure Peripheral IVs?

07 Apr
April 7, 2016

v2 Peripheral IVsBackground: Peripheral venous cannulation is the most frequently performed procedure in the Emergency Department (ED). The vast majority of patients admitted to the hospital will leave the ED with an intravenous catheter (IV). While these devices typically have a “life-span” of 72 hours from placement, they often fail prematurely as a result of infection, phlebitis, occlusion or dislodgement. IV dislodgement is a particular bane to emergency providers and nurses because it often occurs during the patient’s ED stay requiring repeated cannulation and the associated expenditure of time and resources not to mention the additional pain/discomfort to the patient. Inadequate fixation of the catheter is a likely cause of dislodgement but may also contribute to infection and phlebitis due to small movements leading to microtrauma to the vein.

Medical-grade skin glue (cyanoacrylate) has been demonstrated to reduce peripheral arterial line failure rate in prior studies but has not been extensively studied for peripheral IV securing. Read more →

Mythbuster: Administration of Vasopressors Through Peripheral Intravenous Access

28 May
May 28, 2015

VasopressorsBackground: Vasopressors are frequently used in critically ill patients with hemodynamic instability both in the emergency department (ED) as well as intensive care units (ICUs). Typically, vasopressors are given through central venous catheters (CVCs) as opposed to peripheral intravenous (PIV) access due to the concerns about adverse events (i.e. tissue ischemia/necrosis) associated with extravasation through PIVs. In a truly hypotensive, critically ill patient the use of a PIV to administer vasopressors will allow the medication to stabilize the patient sooner and reduce the time to hemodynamic stability. The requirement to start vasopressors through a CVC may delay administration of pressors. Also, performing the insertion of a CVC in a hypotensive patient in an emergency circumstance versus an elective circumstance may increase the risk of adverse events from the procedure itself (i.e. bacteremia, pneumothorax, arterial puncture). Finally, most of the evidence cited for avoiding PIV administration of pressors is a sparse collection of case studies and expert opinion. Read more →

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