Avoiding Idle Peripheral Intravenous Catheters in Taiwanese Emergency Wards: Who Is at Risk?

台灣地區急診患者接受非必要周邊靜脈導管之風險調查

陳立遠(Li-Yuan Chen) ； 李維玲(Wei-Ling Lee) ； 黃政華(Cheng-Hua Huang)

《輔仁醫學期刊》 10卷4期 (2012/12) Pp. 177-184

摘要

Background and purpose: Excessive use of peripheral intravenous catheters (PICs) is associated with greater numbers of complications and higher costs, while patient characteristics and indications associated with idle catheters in emergency wards are rarely reported. Methods: In total, 400 patients who received an empiric PIC in the emergency ward were assigned to either a necessary or idle catheter group according to the inclusion criteria. Their characteristics, presentations, and indications for a PIC were analyzed. Results: Among all catheters, 45% were idle. We found that patients presenting with fever (odds ratio (OR): 8.31), leukocytosis (OR: 1.55), and diarrhea (OR: 10.07) were more likely to have an idle catheter. Patients who received a PIC for electrolyte disturbances also had more idle catheters than those with other indications. Conclusions: We found that nearly half of empiric PICs were idle in our study. Considering the excessive costs, complications, and injuries from PICs, we suggest judicious use of PICs when there are less-invasive and more-effective alternatives.

關鍵字

急診 ； 周邊靜脈導管 ； 靜脈輸液 ； 非必要治療

並列摘要

Background and purpose: Excessive use of peripheral intravenous catheters (PICs) is associated with greater numbers of complications and higher costs, while patient characteristics and indications associated with idle catheters in emergency wards are rarely reported. Methods: In total, 400 patients who received an empiric PIC in the emergency ward were assigned to either a necessary or idle catheter group according to the inclusion criteria. Their characteristics, presentations, and indications for a PIC were analyzed. Results: Among all catheters, 45% were idle. We found that patients presenting with fever (odds ratio (OR): 8.31), leukocytosis (OR: 1.55), and diarrhea (OR: 10.07) were more likely to have an idle catheter. Patients who received a PIC for electrolyte disturbances also had more idle catheters than those with other indications. Conclusions: We found that nearly half of empiric PICs were idle in our study. Considering the excessive costs, complications, and injuries from PICs, we suggest judicious use of PICs when there are less-invasive and more-effective alternatives.

並列關鍵字

emergency ； peripheral venous catheterization ； intravenous infusion ； unnecessary procedure