Sage Journals: Discover world-class research

Abstract

Introduction:

Safe and efficient intravenous access is paramount to the practice of emergency medicine. We compared the first-stick success rates and blood spillage of two peripheral intravenous catheters in a busy urban emergency department.

Methods:

In this randomized controlled trial, we assigned emergency department patients requiring peripheral intravenous access to use of either a flash-tip catheter (SurFlash Plus, Terumo Medical Corporation, Somerset, New Jersey) or a widely used control catheter (Insyte Autoguard; Becton, Dickinson and Company, Franklin Lakes, New Jersey). We compared frequency of first-stick success and blood contamination between catheters using chi-squared analysis.

Results:

We enrolled 600 patients, randomizing 309 to the flash-tip catheter and 291 to the control catheter. The first-stick success rate of each device was 79%. Blood contamination, defined as spillage of blood on the patient’s skin, bedding, or the inserter, occurred in 8 of 309 cases (2.6%) with the flash-tip catheter versus 92 of 291 cases (31.6%) for the control catheter.

Conclusion:

The two catheters tested in this study had comparable rates of first-stick success, but the flash-tip catheter was associated with significantly less blood contamination during insertion attempts.

Keywords

Peripheral catheterization intravenous catheter first-puncture success contamination blood exposure occupational exposure

Get full access to this article

View all access options for this article.

References

Jagger

Perry

Parker

et al . Nursing2011 survey results: blood exposure risk during peripheral I.V. catheter insertion and removal. Nursing 2011; 41(12): 45–49.

Richardson

Kaufman

Reducing blood exposure risks and costs associated with SPIVC insertion. Nurs Manage 2011; 42(12): 31–34.

Jacobson

Winslow

EH.

Variables influencing intravenous catheter insertion difficulty and failure: an analysis of 339 intravenous catheter insertions. Heart Lung 2005; 34(5): 345–359.

Sabri

Szalas

Holmes

et al . Failed attempts and improvement strategies in peripheral intravenous catheterization. Biomed Mater Eng 2013; 23(1–2): 93–108.

Sugita

Kobayashi

Endo

et al . Comparison of Surflo and Surflo-Flash in venipuncture and indwelling of needle. Ohu Univ Dent Hosp J 2001; 28(1): 27–31.

McCarthy

Shokoohi

Boniface

et al . Ultrasonography versus landmark for peripheral intravenous cannulation: a randomized controlled trial. Ann Emerg Med 2016; 68(1): 10–18.

Holdgate

Wong

Does local anaesthetic affect the success rate of intravenous cannulation?

Anaesth Intensive Care 1999; 27(3): 257–259.

Lapostolle

Catineau

Garrigue

et al . Prospective evaluation of peripheral venous access difficulty in emergency care. Intensive Care Med 2007; 33(8): 1452–1457.

Sebbane

Claret

Lefebvre

et al . Predicting peripheral venous access difficulty in the emergency department using body mass index and a clinical evaluation of venous accessibility. J Emerg Med 2013; 44(2): 299–305.

Prospective,randomized controlled comparison of a flash-tip catheter and a traditional intravenous catheter in an urban emergency department