Abstract
Objectives: Peripheral intravenous catheters (PIVC) are the most frequently used invasive devices in medicine. PIVC failure before treatment completion is a significant concern and occurs in 33–69% of patients. Partial dislodgement and accidental removal are some of the reasons for PIVC failure. The most effective dressing and securement method for preventing accidental removal remains unclear. It was the aim of this study to compare the force required to dislodge a PIVC with four commonly used dressing and securement methods. Additionally, costs were calculated. Methods: Truncated 18-gauge i.v. cannulas were attached onto the forearm of 209 volunteers using four different dressings and securements (sterile absorbent wound dressing covered by two different types of elastic polyester fleece, bordered and non-bordered polyurethane). The force during continuously stronger pulling until dislodgement was recorded. Results: The highest resistance against dislodgement forces could be observed with a sterile absorbent wound dressing covered by two incised elastic polyester fleece dressings. Commercially-manufactured bordered and non-bordered polyurethan film dressings were 20% to 75% more expensive than sterile absorbent wound dressings covered by elastic polyester fleece dressing. Conclusions: Elastic polyester fleece secured a PIVC against accidental removal by external force best, compared to commercially-manufactured bordered and non-bordered polyurethane film dressing.
Highlights
Peripheral intravenous catheters (PIVC) are the most frequently used invasive medical devices and are routinely inserted during emergency treatment, anesthesia and critical care
Occlusion and infection, partial dislodgement and accidental removal are some of the reasons for PIVC failure
Force measurements showed the force characteristically increasing with time until the dressings detached from the skin (Figure 4)
Summary
Peripheral intravenous catheters (PIVC) are the most frequently used invasive medical devices and are routinely inserted during emergency treatment, anesthesia and critical care. They are an essential component for the delivery of medication and fluid resuscitation. Occlusion and infection, partial dislodgement and accidental removal are some of the reasons for PIVC failure. PIVC dislodgement and replacement puts patients at risk of hematoma, delays intravenous therapy, drives costs for the institution and may cause pain and anxiety in patients, especially in those with difficult venous access. Dressing and securement of a PIVC are supposed to reduce movement of the catheter at the insertion site, and reduce the risk of external contamination. Given the large number of PIVCs used in hospitals, the strain of financial resources is an additional concern
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