Hi everyone,
Anyone using extended dwell PIV in your institution? Is the product you are using better than the long (1 3/4") angiocath when it come to dwell time, ease of placement, and patient satisfaction ? Do you follow an algorithm for use of extended dwell PIV? Do you use it for both adults and pediatric populations? Any studies done on the effectivity and benefits of extended dwell?
Thanks for your replies.
Extended dwell is not a category of devices. There are many long perpheral catheters now available. This group of catheters ranges from about 1.5 inches up to around 3 inches with multiple types of insertion techniques. Many studies on their use in both adutls and peds. A literature search using long PIV will bring many up.
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
Hi Lynn,
Do you have any recommendation on IV extension tubing change for peripheral IV catheters, especially for peripheral IV catheter replacement based on clinical indications? The INS guidelines recommend to change peripheral IV dressing every 5-7 days, but it does not indicate how often an IV extension set needs to be changed (specific to extension set to the hub of IV catheter). I am in the middle of implemting peripheral IV catheter replacement based on clinical indication instead of routine 96hour replacement. Thank you so much for your help in advance!
Jonghee
Jonghee
Vascular Access Team
Highland Hospital
Rochester, NY
Think about those PIVs with permanently attached extension set such as Nexiva. We have not seen a tremendous increase in infection with t hose catheters and the extension set is never changed. See the SOP on add-on devices which describes situations for changing these devices. There is no set length of time established by evidence, so it is a decision your facility must make. What length of time are your PIVs beling left in place on average? I would probably change the extension set at 7 days if the PIV is still good, but no evidence for this. No evidence to establish the SOP when that was written.
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
I have found that length doesnt matter as much as vein selection. center of forearm or upper arm cephalic vein i have found last a long time. Even without ultrasound, if you pick the smallest gauge you need and the vein is a good size, it will last.
Any time you place brachial or basilic piv (while this is not desirable), get as much catheter in the vein as you can. There is so much movement in those areas that the catheters will slip out of the vein when the pt moves their arm. the only time those last are when you find an access point fairly close to the surface, and you can get a 2.5” in. Braun makes 20g and 22g 2.5 inch now.
Length of catheter must be suffiicent to allow at least 2/3 of total catheter length in vein lumen. So tissue depth has to be considered. High rates of infiltration are reported without sufficient length in vein lumen, so in this manner, length does matter. But you are absolutely correct about site selection in forearm and away from any joint movement.
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