title: Peripheral Intravenous Line Placement and Utilization in an Academic Emergency Department.
abstract: BACKGROUND
  Rising health care costs and increased scrutiny concerning spending have prompted providers and hospitals to identify unnecessary procedures and waste. Peripheral intravenous line (pIV) placement is one of the most common medical procedures performed. A recent study reported that 50% of intravenous lines placed in the emergency department (ED) went unused. If half of all pIVs placed in EDs systemically go unused, the costs and complications associated with pIV placement are unacceptably high.
  
  
  OBJECTIVE
  Our study aims to ascertain the frequency of pIV placement and usage in an urban ED.
  
  
  METHODS
  This was a retrospective review of medical records for consecutive patients seen in an academic ED in June 2014. The following data points were recorded: age, sex, chief complaint, acuity level on admission, pIV placement both prehospital and in the ED, and pIV utilization (for fluids, medications, or contrast administration).
  
  
  RESULTS
  There were 509 charts reviewed, with a median patient age of 40 years. Common chief complaint categories included neurologic, cardiac, and skin/soft tissue. Triage acuity was varied, with a mean of 3.3. A pIV was placed in 55% of subjects. Prehospital providers placed 19%. Of all pIVs placed, 72% were used for the administration of medications, 19% for contrast, and 67% for fluids. Eighty-five percent of pIVs were used; 51% of patients with a pIV were admitted from the ED.
  
  
  CONCLUSIONS
  In this study's ED, 85% of pIVs were used prior to discharge. Strategies to lower pIV placement rates should focus on alternative routes of medication and fluid administration.
authors.affiliation: Evidence Based Medicine, Department of Emergency Medicine, Oklahoma University, Tulsa, Oklahoma; Department of Emergency Medicine, Oklahoma University, Tulsa, Oklahoma.
authors.forename: Joshua
authors.initials: J
authors.lastname: Gentges
authors.affiliation: Department of Emergency Medicine, Oklahoma University, Tulsa, Oklahoma.
authors.forename: Annette
authors.initials: A
authors.lastname: Arthur
authors.affiliation: Oklahoma University School of Community Medicine, Tulsa, Oklahoma.
authors.forename: Tessa
authors.initials: T
authors.lastname: Stamile
authors.affiliation: Department of Emergency Medicine, Oklahoma University, Tulsa, Oklahoma.
authors.forename: Michael
authors.initials: M
authors.lastname: Figureido
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000328:Adult; D002406:Catheterization, Peripheral / Q000706:statistics & numerical data*; D003287:Contrast Media / Q000008:administration & dosage; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005440:Fluid Therapy; D006760:Hospitalization / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D012189:Retrospective Studies; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D004364:Pharmaceutical Preparations
keywords: emergency; intravenous; peripheral; utilization