Establishment of peripheral intravenous catheter for pediatric patients in the emergency department: who and how?

Abstract

Purpose Peripheral intravenous cannulation (PIC) for children is technically difficult. We aimed to investigate factors associated with the primary success of PIC for children in the emergency department (ED). Methods This prospective observational study was conducted on children younger than 3 years who visited the ED from September 2014 to August 2015. The children undergoing primary success, defined as success at the first attempt, comprised the success group. Using a case report form, information about the children (age, sex, and weight), practitioners’ occupation (doctors, nurses, emergency medical technicians [EMTs]), treatment venue, insertion site of PIC, presence of guardians, and use of auxiliary devices were collected and compared between the success and failure groups. Multivariable logistic regression models were constructed to identify factors associated with the primary success. Results Of 439 children, 271 underwent the primary success (61.7%). The success group showed older age, heavier weight, and higher proportion of EMT. No differences were found in treatment venue, insertion site, and presence of the guardian. We found that patients’ age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.003-1.1), and practitioners’ occupation (EMT; OR, 3.0; 95% CI, 1.9-4.7, compared with doctors) were the factors associated with the primary success. Conclusion Practitioners’ occupation (EMT) and children’s age (older) may be associated with the primary success of PIC. It may be helpful to have specialized personnel when performing PIC on children in the ED.

Keywords

• catheterization, peripheral
• catheters
• emergency service, hospital
• occupations
• pediatrics
• veins