Related Experiment Video
Updated: Nov 27, 2025
09:57
A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
13.5K
Implementation of a Protocol for Peripheral Intravenous Norepinephrine: Does It Save Central Line Insertion, Is It
Kari M Cape1, Laureen G Jones1, Michele L Weber1
112306The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Journal of Pharmacy Practice
|December 3, 2020
Summary
Norepinephrine can be safely administered via peripheral IV (PIV) for short durations, reducing the need for central venous catheters (CVC) and associated complications.
Area of Science:
- Critical Care Medicine
- Pharmacology
- Vascular Access
Background:
- Central venous catheters (CVC) are standard for norepinephrine due to ischemia risks.
- Peripheral intravenous catheters (PIV) may offer a safer alternative if infusion duration is limited.
Purpose of the Study:
- To evaluate a protocol for peripheral norepinephrine administration.
- To assess the safety, CVC placement rates, and adherence to protocol elements.
Main Methods:
- Prospective observational pilot study in a Medical Intensive Care Unit (MICU).
- Norepinephrine via PIV for low doses (<24 hours) based on clinical status.
- Protocol included PIV gauge, number, site criteria, and regular visual inspection.
Main Results:
- 34% of 92 PIV infusions did not require CVC.
- 3 PIV infiltrations occurred without tissue injury.
- High adherence to infusion duration (97% <24 hours) and catheter gauge (91%).
Conclusions:
- Norepinephrine is safe via PIV at low doses for <24 hours under protocol.
- Peripheral administration can prevent unnecessary CVC insertions, reducing patient morbidity.
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
482
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
482
01:26Cardiac Catheterization IV: Nursing Management
417
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
417
01:29Endocarditis IV: Nursing Management
164
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
164
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
879
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
879
01:28Cardiac Catheterization I: Pre-Procedure Overview
589
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
589
01:22Aneurysm IV: Nursing Management
226
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
226