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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
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Difficult intravenous access in a paediatric intensive care unit.
M de la Vieja-Soriano1, M Blanco-Daza1, S Macip-Belmonte1
1Servicio de Cuidados Intensivos Pediátricos, Hospital Universitario 12 de Octubre, Madrid, España.
Enfermeria Intensiva
|July 11, 2021
Summary
Difficult venous access (DVA) is common in pediatric intensive care units (PICU), leading to more complications and requiring more nursing time. Improving first-attempt cannulation success rates is crucial for patient care.
Area of Science:
- Pediatric Intensive Care
- Vascular Access Procedures
- Nursing Research
Background:
- Multiple attempts at peripheral cannulation pose significant risks to patients, families, and healthcare providers.
- The prevalence and impact of difficult venous access (DVA) in a pediatric intensive care unit (PICU) setting require thorough investigation.
Purpose of the Study:
- To describe peripheral venous catheter (PVC) and peripherally inserted central catheter (PICC) cannulation in PICU patients.
- To determine the first-attempt success rate for venous cannulation.
- To quantify the incidence of DVA and explore its associations with patient and procedural factors.
Main Methods:
- A cross-sectional descriptive study design was employed.
- Consecutive sampling included pediatric patients (0-18 years) requiring peripheral venous cannulation in the PICU.
- Data were collected using an ad hoc questionnaire, incorporating DVA as a key variable.
Main Results:
- A total of 163 venous cannulations were analyzed, with 55.8% in patients under one year old.
- The first-attempt success rate was 38.7%, and 36.8% of patients presented with DVA.
- Patients with DVA experienced higher complication rates (85%), longer cannulation times (median 30 minutes), and required more nursing staff (80% of cases involved 2+ nurses).
Conclusions:
- A low first-attempt success rate and a high proportion of DVA were observed in the PICU.
- DVA was significantly associated with increased nursing time, complications, and specific patient characteristics (age, weight, perfusion, vein quality, DIVA score).
- These findings highlight the need for strategies to improve venous cannulation success and manage DVA in critically ill children.
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