Relevance and complications of intravenous infusion at the emergency unit at Nice university hospital.
OBJECTIVE
Insertion of peripheral venous catheters (PVCs) is current practice within the hospital environment and particularly in the emergency department (ED). This simple yet invasive technique may result in venous thrombosis, infection or mechanical complications. We conducted a prospective study at the Nice University Hospital ED in order to determine the frequency, relevance and complications of peripheral venous cannulation.


METHODS
Fourteen 24 h periods were surveyed over the months of May and June 2000, during which 2515 patients over 16 years of age attended the unit. Demographic and medical data were recorded for every patient who received a PVC. These patients were followed at 12 h intervals until the catheter was removed. Reasons for PVC, time left in place, and eventual complications were recorded. Justification for PVC was evaluated upon arrival at the ED, upon exiting the ED and in some cases within the hospital ward.


RESULTS
Six hundred and thirty of 2515 patients (25%) received a PVC (290 women (46%) and 340 men (54%); meanage 58 years). Indication for the PVC was considered unjustified in 24.8% of cases upon arrival at the ED, and 33.8% upon leaving the ED. Upon admission in a hospital ward after passing through the ED, out of 318 patients, the PVC was left in place for no reason in 63 (20%). Overall, 390 PVCs were followed until the time of their removal. Mean duration of IV infusion was 28 h. Among these 390 patients, 62 (15.9%) developed complications, of which 54 (13.6%) had thrombophlebitis and 9 (2.3%) developed local infection. Mean duration of PVC left in place for patients with complications was 50 h vs 25 h for patients with no complications (P<0.001).


CONCLUSIONS
Insertion of a PVC is common practice especially in EDs. The excessive use of this procedure leads to extra cost and iatrogenic complications. A renewed definition of its indication and raised awareness among hospital staff concerning the risks involved with this standard procedure should result in less use of PVC and fewer complications.
Vandenbos
F
F
Service de Maladies Infectieuses et Tropicales, Hôpital de l'Archet 1 CHU de Nice, 151 Rte St Antoine de Ginestière, BP, 3079-06202, Nice cedex 3, France. vandenbos.f@chu-nice.fr
Basar
A
A
Tempesta
S
S
Fournier
J P
JP
Bertrand
F
F
Vanesland
L
L
Oualid
H
H
Dunais
B
B
Dellamonica
P
P
Roger
P M
PM
D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies