The reference is the CDC guidelines and the INS standards of practice. Both documents states that any catheter - PIV and CVC - started in any emergent situation when proper aseptic technique can not be used should be changed as soon as the patient is stable or within 48 hours. So all starts by EMS may not be under truly emergent conditions where the proper technique can not be observed. This also applies to all catheters started in the hospital under emergent conditions. So you can not think about this as applying to only a certain environment or group of personnel. It is the situation, regardless of where the patient is, what professional is doing it, and it applies to all catheters. So even a CVC that was placed during a crisis situation where proper skin antisepsis and max barriers can not be used should be changed within 48 hours. The reason is that these catheters have a much higher rate of CRBSI. The problem is finding a successful method for identifying these catheters correctly and communicating that fact to the subsequent caregivers.
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Office Phone 770-358-7861