Doomed peripheral intravenous catheters: Bad Outcomes are similar for emergency department and inpatient placed catheters: A retrospective medical record review

INTRODUCTION: The survivorship of peripheral intravenous catheters (PIVCs) placed in hospitalized patients is shockingly poor and leads to frequent reinsertions. We aimed to evaluate differences in failure rates and IV insertion practices for PIVCs that are placed in the emergency department (ED) compared to those placed in the inpatient (IP) setting. METHODS: We conducted a retrospective electronic medical record review of PIVC survival at a single-site suburban, academic tertiary care referral center with 130,000 annual ED visits and 1100 inpatient beds. Adult patients admitted requiring at least one PIVC were included. The primary outcome was incidence of premature failure of PIVCs. Secondary outcomes included dwell time, completion of therapy, catheter diameter, and site of insertion as they relate to PIVC survival. The antecubital fossa and forearm had the lowest failure rate of 53% and 50%, respectively, and 22 gauge PIVCs had the highest failure rate of 60.5%. CONCLUSION: PIVCs have similar poor survival rates regardless of ED versus IP location of the insertion. The forearm and antecubital fossa sites should be preferentially used. Smaller diameter (22G) catheters have highest complications and poorest survival regardless of site of insertion. Larger diameter catheters (18 or 20 gauge) may offer improved outcomes.