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Evaluation of use and identification of predictive factors for nonuse of peripheral venous catheters in the emergency department

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Abstract

The placement of peripheral venous catheters (PVC) is a frequent procedure in the emergency department (ED), which exposes patients to complications (hematoma, fluid leakage, phlebitis, edema, infection), increases hemolysis of blood samples, is time-consuming and costly. The main aim of this study is to analyze the rate of PVC nonuse in the ED and to identify predictive factors of their nonuse. This prospective single-center observational study was conducted in the ED of the Saint-Antoine Hospital in Paris, France between February and March 2022. Adult patients receiving a PVC were included. In addition to demographic and medical data, the reason for PVC prescription and the prescribing physician’s expectation of PVC use were collected. A total of 304 patients were included, with a median age of 61.5 years (IQR: 43–79 years), of whom 152 (50%) were men. PVC were primarily prescribed for intravenous medication administration. Seventy-two (23.7%) PVC were not used. In multivariable analysis, the predictive factors of nonuse were the prescribing physician’s expectation of nonuse [OR 6.35, CI 95% (2.64–15.29), for "no" and "not sure" vs. "yes" responses] and the reason for prescribing "just in case" [OR 3.54, CI 95% (1.37–9.17)]. PVC were not used in 23.7% of cases. Predictors of nonuse were the prescribing physician’s expectation of nonuse and the reason for prescribing "just in case". A PVC should probably not be prescribed if the prescribing physician thinks it will not be used or prescribes it "just in case".

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All data analyzed during this study are included in this article.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Service d’Accueil Des Urgences, Hôpital Saint Antoine, AP-HP.Sorbonne Université, 184, Rue du Faubourg Saint-Antoine, 75012, Paris, France

    Florent Noel, Aurélie Lefèvre, Youri Yordanov & Pierre-Clément Thiebaud

  2. Statistical Unit, EBMT, Paris, France

    Jacques-Emmanuel Galimard

  3. Service d’Accueil Des Urgences, Hôpital Cochin, AP-HP.Université de Paris Cité, Paris, France

    Célina Pognonec

  4. Service d’Accueil Des Urgences, Hôpital Henri Mondor, AP-HP.Hôpitaux Universitaires Henri Mondor, Créteil, France

    Christian Kassasseya

  5. Service d’Accueil Des Urgences, Hôpital Tenon, AP-HP.Sorbonne Université, Paris, France

    Sofiane Yefsah

  6. Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, UMR-S 1136, Paris, France

    Youri Yordanov & Pierre-Clément Thiebaud

Authors
  1. Florent Noel
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  2. Aurélie Lefèvre
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  3. Jacques-Emmanuel Galimard
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  4. Célina Pognonec
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  5. Christian Kassasseya
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  6. Sofiane Yefsah
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  7. Youri Yordanov
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  8. Pierre-Clément Thiebaud
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Contributions

Conceptualization, Methodology: Florent Noel, Aurélie Lefèvre, Pierre-Clément Thiebaud; Investigation: Aurélie Lefèvre, Célina Pognonec, Christian Kassasseya, Sofiane Yefsah, Youri Yordanov, Pierre-Clément Thiebaud; Data curation, Data interpretation: Florent Noel, Pierre-Clément Thiebaud; Formal analysis: Florent Noel, Jacques-Emmanuel Galimard; Writing—original draft: Florent Noel, Pierre-Clément Thiebaud; Writing—review & editing: Aurélie Lefèvre, Jacques-Emmanuel Galimard, Célina Pognonec, Christian Kassasseya, Sofiane Yefsah, Youri Yordanov; Supervision: Pierre-Clément Thiebaud.

Corresponding author

Correspondence to Pierre-Clément Thiebaud.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Human and animal rights

This study involving the reuse of routinely collected data fell within the scope of the MR-004 reference methodology of the French legislation. The study protocol was approved by the Sorbonne University research ethics committee and registered in the Assistance Publique-Hôpitaux de Paris studies registry (number 20211215100450).

Informed consent

Patients were given an information leaflet and their verbal non-opposition was recorded. Physicians were informed about the study and agreed to have their prescription data analyzed.

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Noel, F., Lefèvre, A., Galimard, JE. et al. Evaluation of use and identification of predictive factors for nonuse of peripheral venous catheters in the emergency department. Intern Emerg Med (2024). https://doi.org/10.1007/s11739-024-03603-w

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