Pediatric intravenous line longevity
CPS ePoster Library. Soper J. Jun 25, 2015; 99194; 132
Dr. Juliet Soper
Dr. Juliet Soper
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Background: Peripheral Intravenous (IV) insertion in children is a traumatic procedure. Minimizing the number of IV lines a child needs throughout an admission improves the child’s care experience.
Objective: To identify modifiable factors affecting longevity of peripheral IV lines in children.
Design/Method: A retrospective chart review of IV lines on the pediatric ward in a small urban center (approximately 1700 admissions per year) was conducted between December 1st, 2013 and February 28th, 2014. IV lines which were removed because they were no longer required within 48 hours of insertion were excluded. The length of time an IV line spent in situ, its uses, location, and catheter size, and the reason for removal were recorded. Time spent saline locked or running at a rate of up to 10ml/hour ‘to keep vein open’ (TKVO) was also recorded for each line. Chi-square, Fisher Exact, and Mann-Whitney U tests were used to identify factors associated with IV line longevity. The primary outcome in this analysis was survival of IV line at 48 hours after insertion, as this is a common duration of antibiotics for children awaiting negative culture results. This study received local ethics board approval, and did not have any funding sources.
Results: A total of 284 IV lines were reviewed; 139 IV lines met the inclusion criteria. Lines remained in situ for a median of 62.3 hours (range 0.3-368.5, interquartile range 36.0, 77.0). 59% (n=55) of lines which lasted more than 48 hours spent greater than 20% of the IV duration TKVO compared to 28% (n=13) of lines which failed prior to 48 hours (p=0.001). Catheter size (p=1.0), insertion site (p=0.23), spending greater than 20% of line duration saline locked (p=0.67), and running fluids and/or medications at a rate above 10ml/hour for greater than 20% of line duration (p=0.81) were not associated with IV line longevity.
Conclusion: In this retrospective analysis, greater percentage of time spent TKVO was associated with greater total IV line duration. Increased time spent saline locked was not associated with increased line longevity.
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