Evidence map›Paper›PMID 38875242›Full record

Observational studyPloS one2024

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

Michael Willis, Efrem Colonetti, Ali Bakir, Yousef Jamal Alame, Megan Annetts, Deren T Aygin, Amina Daou, Sultan Farooq, Nicholas A Fine, Gozde Firat and 10 more

Abstract readObservational Study
In one paragraph

Observational study in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Michael WillisBarts Health NHS Trust, London, England.ORCID 0000-0001-7759-0449
Efrem ColonettiDepartment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy.ORCID 0000-0003-3942-4604
Ali BakirThe Ivers Practice, Iver, England.
Yousef Jamal AlameHampshire Hospital NHS Foundation Trust, Hampshire, England.
Megan AnnettsMonash Children's Hospital, Melbourne, Australia.ORCID 0000-0001-9177-8376
Deren T AyginMid and South Essex NHS Foundation Trust, Chelmsford, England.ORCID 0000-0002-9104-4601
Amina DaouGuy's and St Thomas' NHS Foundation Trust, London, England.
Sultan FarooqWhittington Health NHS Trust, London, England.
Nicholas A FineBarts Health NHS Trust, London, England.
Gozde FiratThe Royal Free London NHS Foundation Trust, London, England.
Benjamin GoozeeSt John of God Subiaco Hospital, Perth, Australia.
Anuj Neelesh GuptaDorset County Hospital NHS Foundation Trust, Dorchester, United Kingdom.
Charlotte HubbettBarts Health NHS Trust, London, England.
Nicole Shun Yee LoiThe Prince Charles Hospital, Brisbane, Australia.
Laura Maciejec-BiskupRoyal North Shore Hospital, Sydney, Australia.
Merline Gabriela MuthukumarLewisham and Greenwich NHS Foundation Trust, London, England.ORCID 0000-0001-9351-0285
Jason PottBarts Health NHS Trust, London, England.ORCID 0000-0003-2068-0560
Benjamin M BloomBarts Health NHS Trust, London, England.
Maria Lorenza MuiesanDepartment of Clinical and Experimental Sciences University of Brescia, Brescia, Italy.ORCID 0000-0002-4007-9441
Tim HarrisBarts Health NHS Trust, London, England.ORCID 0000-0002-9146-258X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeripheral 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.

methodsThe 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.

resultsA 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.

conclusionsMore 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.

Indexed as

Catheterization, PeripheralEmergency Service, HospitalAdministration, IntravenousAdultAgedAged, 80 and overCannulaFemaleFluid TherapyHumansMaleMiddle AgedPhlebotomyProspective StudiesUnited Kingdom

Identifiers

PMID38875242
PMCPMC11178163

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.