Peripheral intravenous catheter use in French emergency departments (CathIRU study): a multicentre cross-sectional...

Peripheral intravenous catheters (PIVCs) are widely used in emergency departments (EDs), but many are inserted without subsequent use, exposing patients to avoidable risks and wasting resources. We determined the prevalence of non-indicated PIVCs in French EDs and identified associated patient-, treatment- and unit-specific factors.

We conducted a multicentre, observational, cross-sectional (point prevalence) study across 81 EDs over 48 h in April 2025. Adult patients (age over than 18 years) having PIVC placement during their ED stay were eligible. Patients with an existing PIVC in place, life-threatening and conditions precluding data collection were excluded. For patients receiving multiple PIVCs, only the first successfully inserted PIVC was eligible. The primary outcome was the prevalence of non-indicated PIVCs, defined as (1) no use for fluids, intravenous medication, contrast agents, or blood transfusion administration within 24 h, or (2) absence of predefined high-risk deterioration scenarios. Multivariable regression identified the risk factors.

Among 19,737 ED visits across 81 EDs, and after exclusion of 96 duplicate catheters and 403 catheters with missing primary endpoint, 3909 PIVCs inserted were analysed. Overall, 35% (1368/3910, 95% CI 30-36) were classified as non-indicated. Contributing factors included low-acuity triage and low nurse-to-patient ratios. Protective factors were age over 60 years, known difficult intravenous access (DIVA), high-acuity triage and dedicated vascular access teams.

In this study, one-third of PIVCs were non-indicated and were mainly associated with low-acuity clinical presentations and organisational factors. These findings highlight substantial opportunities to improve the appropriateness of PIVC use in emergency care.

French Society of Emergency Medicine (€10,000 for administrative setup and data management).