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Extension Set Requirement

What are your thoughts on the presence of extension sets on peripheral IV's? Also with the introduction of newly designed midlines, what are your thoughts on using extension sets on them?
Are they absolutely needed, a nice to have or not really needed?

(Keep in mind that these catheters are using in acute and home care patients.)

Cheryl Kelley RN BSN, VA-BC
Clinical Marketing Manager
Terumo Medical

I have found that this varies

I have found that this varies in the home care setting depending on the situation. If the patient is going to be performing the infusion therapy then extensions are a must on both PIVs and PICCs. On rare occasion, the patients do not want to have anything to do with the infusion so the spouse/caregiver is taught and no extensions are needed. I always use at least a 6" extension on my PIVs. Hope this helps :) Valorie

Valorie Dunn,BSN, RN, CRNI, PLNC

 In my opinion, all PIVs

 In my opinion, all PIVs require an extension set. There are numerous benefits. It separates the HCW's hands from the source of the blood and provides a clamp to stop the backflow. It allows for use of the line without going directly to the catheter hub, causing increased hub manipulation and increases the risk of phlebitis and infiltration. It allows for easy conversion from a continuous infusion to an intermittent infusion without disruption of the dressing and manipulation of the catheter hub. I also strongly believe that this extension set should NOT have a fixed needleless connector on it as the NC is NOT required for continuous infusion and should only be used when there is intermittent infusion. Finally, there is a risk of contamination when any set or NC is attached to the hub of a catheter with blood pouring out. This could be an unidentified factor that increases BSI associated with PIVs. Although no one is collecting data on PIV-BSI, I know from speaking to many infection preventionists that it is a problem. There is very little evidence to support my opinion, but we do see brands of PIVs with a permanent extension sets already attached. A great idea in my opinion. hope this helps, Lynn

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

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