Remove PIVC if No IV Therapy Is Indicated to Enhance Comfort, Minimize Complications

Background: Peripheral IV catheters (PIVCs) are common in hospitalized patients, but approximately one-third are not actively used. One-third of PIVCs placed in the emergency department are never used. Because they are so common, they account for 30% of catheter-related Staphylococcus aureus bloodstream infections and 20% of all S aureus bloodstream infections. Pain, phlebitis, and vascular damage occur with 10% to 20% of peripheral IVs. They can be problematic in agitated delirious patients and burdensome to maintain. Hospitalists may feel peripheral access is necessary in case emergent IV therapy is required. Objective: To review when the benefit of PIVCs outweighs risk. Design: Literature review in the "Things We Do For No Reason™" series. Discussion: The authors report that 10% of PIVCs in 1 survey were malfunctioning, and 30% failed before the end of therapy. Interosseous (IO) IV access was used in 20% of emergent cardiac resuscitations with no difference in outcomes. PIVCs are more...