Pain upon inserting a peripheral intravenous catheter: Size does not matter

Loon, Fredericus H. J. van; Puijn, Lisette A. P. M.; Aarle, Wesly H. van; Daele, A.T.M. Dierick-van; Bouwman, R. Arthur

doi:10.1177/1129729817747531

Cited by 30 publications

(23 citation statements)

References 42 publications

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“…This is in line with the findings in this study [30,35]. Likewise, a smaller diameter of the target vein was reported as a risk factor for failure upon the first attempt of intravenous cannulation in previous publications [7,11]. Bensghir and colleagues reported an increased rate of failure upon the first attempt of cannulation when the intravenous catheter was inserted by nurses and physicians in training, although no differences between the practitioners on the success rates were observed in the present study [28].…”

Section: Discussionsupporting

confidence: 93%

“…Although peripheral intravenous cannulation is the most common invasive hospital procedure performed worldwide, it is associated with an unacceptable high overall failure rate [5,6]. An unsuccessful attempt of intravenous cannulation poses a burden to patients, caregivers, and the healthcare system, because of an increasing number of painful and stressful punctures, nursing and medical workload, and catheter-related infections and phlebitis [5,7,8].…”

Section: Introductionmentioning

confidence: 99%

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The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study

Loon

Hooff

Boer

et al. 2019

JCM

137

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Peripheral intravenous cannulation is the most common invasive hospital procedure but is associated with a high failure rate. This study aimed to improve the A-DIVA scale (Adult Difficult Intra Venous Access Scale) by external validation, to predict the likelihood of difficult intravenous access in adults. This multicenter study was carried out throughout five hospitals in the Netherlands. Adult participants were included, regardless of their indication for intravenous access, demographics, and medical history. The main outcome variable was defined as failed peripheral intravenous cannulation on the first attempt. A total of 3587 participants was included in this study. The first attempt success rate was 81%. Finally, five variables were included in the prediction model: a history of difficult intravenous cannulation, a difficult intravenous access as expected by the practitioner, the inability to detect a dilated vein by palpating and/or visualizing the extremity, and a diameter of the selected vein less than 3 millimeters. Based on a participant’s individual score on the A-DIVA scale, they were classified into either a low, moderate, or high-risk group. A higher score on the A-DIVA scale indicates a higher risk of difficult intravenous access. The five-variable additive A-DIVA scale is a reliable and generalizable predictive scale to identify patients at risk of difficult intravenous access.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study

Loon

Hooff

Boer

et al. 2019

JCM

137

View full text Add to dashboard Cite

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“…Although venous puncture is generally considered to generate only low-intensity pain, our study confirms previous research findings that there is a clinically significant difference between the sensation of pain described by patients with DPIVC and that of patients who do not present this difficulty [29,30]. Situations of difficult access, as well as provoking multiple punctures, often result in cannulation manoeuvres that generate more tissue damage, with possible adverse effects for the patient, thus degrading the quality of healthcare and the user's satisfaction [3,31,32].…”

Section: Discussionsupporting

confidence: 86%

Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study

Rodríguez-Calero

Pedro-Gómez

Molero-Ballester

et al. 2020

JCM

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Background. Difficult peripheral intravenous cannulation (DPIVC) is associated with serious complications related to vascular access. These complications might be avoided if the risk factors were identified previously, enabling the detection of potentially difficult situations at an early stage. The aim of this study is to consider these risk factors, to determine the influence of the hospital setting, to examine the association between DPIVC and the different techniques of catheter insertion and to analyse the importance of the clinician’s experience in this context. Methods. Case-control study following a previously published protocol, conducted in 48 units of eight public hospitals in Spain. Adult patients requiring a peripheral intravenous cannula were prospectively included in the study population during their hospital stay. Over a period of 11 months, for consecutive eligible patients, nurses in each participating unit recorded data on their assessment of the vascular access performed and the technique used. Variables related to these medical personnel were also recorded. One of the researchers reviewed the patients’ clinical history to compile the relevant health variables and to characterise the healthcare process. The statistical analysis included association tests among the main study variables. The risk factors were analysed using bivariate logistic regression. The variables found to be statistically significant were included in a multivariate logistic regression model incorporating each of the healthcare environments identified. Results. The study population was composed of 2662 patients, of whom 221 (8.3%) presented with DPIVC. A previous history of difficulty, the presence of non-palpable veins, acute upper limb alterations and punctures in the ante-cubital fossa were found to be independent risk factors for DPIVC. Differences were found in the frequency of occurrence of DPIVC and in some risk factors, according to the healthcare context. The variables related to the characteristics of the hospital personnel did not influence the study event. Conclusion: The present study identifies four independent risk factors for DPIVC that can be incorporated into algorithms aimed at preventing its occurrence and facilitating the referral of patients to vascular access specialist teams.

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“…The diameter of the dilated target vein was, on the contrary, increased significantly in participants from intervention group 1 (p = 0.03, U = 731, Z = -2.78) and intervention group 2 (p = 0.01, U = 635, Z = -3.43) when compared to the control group, although there was no significant difference between these two intervention groups (p = 0.35, U = 1027, Z = -0.94). Despite, no clinically relevant difference could be objected in dilated vein diameter between the control group, intervention group 1, and intervention group 2, with diameters of, respectively, 3 (1-5), 3 (1)(2)(3)(4)(5)(6)(7)(8), and 3 (1-7) mm. Other data related to either the procedure of peripheral intravenous cannulation or regarding the applied intervention throughout the study were comparable between the three study groups, as represented in Table 2.…”

Section: Resultsmentioning

confidence: 87%

Clinical use of electrical stimulation with the Veinplicity^® device and its effect on the first attempt success rate of peripheral intravenous cannulation: A non-randomized clinical trial

et al. 2019

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Background: Peripheral intravenous cannulation is one of the most frequently performed medical procedures. Venodilation, which can be achieved with different techniques, is an important factor for first attempt success. The objective of this study was to compare the first attempt success rates upon peripheral intravenous cannulation after applying a tourniquet, with venous dilation by electrical stimulation using the Veinplicity® device, or a combination of both techniques, in participants at moderate risk of a difficult peripheral intravenous access. Methods: This non-randomized clinical trial was carried out in adult patients divided into three parallel study groups, consisting of cannulation with a tourniquet (control group), cannulation after electrical stimulation without using a tourniquet (intervention group 1), and cannulation after applying electrical stimulation followed by the application of a tourniquet on the selected upper extremity (intervention group 2). The primary outcome was the first attempt success rate of peripheral intravenous catheter placement. Results: In all, 141 participants were included in this study, with an overall success rate of 86%. Success rates of 78%, 88%, and 92% were observed in the control group, intervention group 1, and intervention group 2, respectively ( p = 0.25, χ2 = 2.771, df = 2). A higher first attempt success rate was detected in participants in intervention group 2, when compared to the control group ( p = 0.04, χ2 = 4.63, df = 1). Conclusion: Increase in first attempt success was clinically relevant when electrical stimulation with the Veinplicity® device was combined with the application of a tourniquet in participants at moderate risk of a difficult peripheral intravenous access.

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Pain upon inserting a peripheral intravenous catheter: Size does not matter

Abstract: Inserting a smaller sized peripheral intravenous catheter did not result in a lower pain sensation. Moreover, to prevent pain upon inserting a peripheral intravenous catheter, an unsuccessful attempt must be avoided.

Cited by 30 publications

References 42 publications

The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study

The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study

Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study

Clinical use of electrical stimulation with the Veinplicity^® device and its effect on the first attempt success rate of peripheral intravenous cannulation: A non-randomized clinical trial

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Pain upon inserting a peripheral intravenous catheter: Size does not matter

Abstract: Inserting a smaller sized peripheral intravenous catheter did not result in a lower pain sensation. Moreover, to prevent pain upon inserting a peripheral intravenous catheter, an unsuccessful attempt must be avoided.

Cited by 30 publications

References 42 publications

The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study

The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study

Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study

Clinical use of electrical stimulation with the Veinplicity® device and its effect on the first attempt success rate of peripheral intravenous cannulation: A non-randomized clinical trial

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Product

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About

Clinical use of electrical stimulation with the Veinplicity^® device and its effect on the first attempt success rate of peripheral intravenous cannulation: A non-randomized clinical trial