A survey of UK emergency departments reveals that only 15% account for peripheral cannula dead space when starting nitrate infusions, likely causing undertreatment in severe cardiogenic pulmonary edema.
May risk nitrate dosing errors in UK EDs; leaves open whether education improves priming practices.
OBJECTIVE: To determine if peripheral intravenous cannula dead space is taken into account when setting up intravenous infusions (in particular nitrate infusions) in the emergency department. METHOD: A postal survey of UK emergency departments. RESULTS: Of the 143 (58%) of UK departments who responded, only 15% reported priming the cannula before commencing the nitrate infusion. CONCLUSIONS: Knowledge of peripheral intravenous cannula dead space in UK emergency departments is very poor and, as a result, there is probably significant widespread under treatment of patients in severe cardiogenic pulmonary oedema. Departments should amend their treatment guidelines to take account of peripheral cannula dead space.
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Geggie et al. (2007) studied this question.
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