Avoid Peripheral IV Access in Hospitalized Patients Without Good Reason

Background: Peripheral intravenous catheters (PIVCs) are commonly used in the hospital. Objective: To review the risks and benefits of routine PIVC access in hospitalized patients. Design: Narrative review. Discussion: Approximately one-fourth of PIVCs in hospitalized North American patients are “idle” (maintained but not actively used). Risks to PIVCs include local infection (65 per 100,000 catheter-days) and bacteremia (4.4 per 100,000 catheter-days). Because of how much more common they are than central venous catheters, PIVCs are estimated to cause approximately one-third of catheter-related Staphylococcus aureus bacteremia. Furthermore, PIVCs are frequently unreliable. In one study of patients with in-hospital cardiac arrest, there was no difference in the groups resuscitated with a PIVC compared to those who required emergent intraosseous access. Conclusions: Avoid routine PIVCs in hospitalized patients without clear indications. Reviewer's Comments: For those unfamiliar with J more...