“Just in case”. Use of large-bore peripheral intravenous catheters in parturient women: A global study

Objective: The aim of the current study was to map a global picture of the practice of inserting large-bore peripheral intravenous catheters in parturient women. Methods: We analysed a sub-set of data from a prospective, multi-centre, international prevalence study, the One Million Global peripheral intravenous catheter study. The obstetric cohort was drawn from 163 maternity units in 35 countries (1477 women, 1577 catheters) and was collected between 1 June 2014 and 31 July 2015. Clinicians at each of the participating sites collected data using tools that had been previously validated. Results are reported as frequencies and proportions. Results: Overall, 42% of all peripheral intravenous catheters were large bore and of all catheters placed in females in obstetric units, 438 (70%) of these were placed in the hand or wrist. The phlebitis rate was higher in the large-bore group (12%) compared with those with smaller catheters (7%). Only 2% of women received blood products, but it was unclear which catheter was used for this purpose. Conclusion: Large-bore peripheral intravenous catheters are overused for vascular access in parturient women. They are painful and may cause vascular damage. If there is no indication, a catheter should not be placed at all.