During a presentation at a recent Vascular Access Conference, one of the speakers stated that evidence shows that larger peripheral catheters should be inserted at a 15 degree angle so that the angle is less acute with less bending where it enters the vein thus decreasing chance of a thrombus at the site. Makes sense but wondering if there is any study on this.
Thanks,
Chris
Shame on the presenter for not providing the evidence to support their statements. All PIVs have stated instructions for 10-15 degrees as angle of insertion for many years now. Prevention of backwalling is the original reason. Prevention of kinking is another reason. Transition from skin surface to subq and from subq to vein lumen creates 2 areas where sharp angles can cause kinking. Angle of the catheter as it lies in the vein lumen can bring the catheter into greater contact with the vein wall, disrupting endothelial layer and producing thrombophlebiits. I am not aware of any studies actually proving this, but reasonable theory.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Agreed. No resource given and everything you said is so logical it's almost a no brainer for any experienced nurse. Less obvious to the novice so will explain in a course I am teaching. Infusion Nursing states 10 to 30 degrees but of course to decrease the degree once skin is penetrated. I can understand that also with certain skin types. Unfortunately, new nurses are so concerned about exact numbers in policy instead of critical thinking.
Agreed. No resource given and everything you said is so logical it's almost a no brainer for any experienced nurse. Less obvious to the novice so will explain in a course I am teaching. Infusion Nursing states 10 to 30 degrees but of course to decrease the degree once skin is penetrated. I can understand that also with certain skin types. Unfortunately, new nurses are so concerned about exact numbers in policy instead of critical thinking.
I know what you mean about the need for more critical thinking! But everything is not black and white!
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861