Peripheral catheterization: Difference between revisions
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In [[medicine]], '''peripheral catheterization''' is "insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes"<ref>{{MeSH}}</ref> such as [[intravenous infusion]] of [[medication]]s or [[fluid therapy]]. This is in contrast to [[central venous catheterization]]. | In [[medicine]], '''peripheral catheterization''' is "insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes"<ref>{{MeSH}}</ref> such as [[intravenous infusion]] of [[medication]]s or [[fluid therapy]]. This is in contrast to [[central venous catheterization]]. | ||
==Equipment and procedure== | |||
Intravenous catheterization is most common. An area over a suitable vein is cleaned, and one of two types of catheter insertion devices is used. One uses a large-bore metal needle inside which is a plastic catheter, and the other uses a plastic catheter over a stiffening sharp metal core. Once in the vein, the metal device is removed, the catheter attached to the fluid delivery system, and a sterile adhesive dressing put over the puncture site, both to protect it from infection and to keep the catheter in place. | |||
[[Ultrasonography]] may be used to guide catheterization.<ref name="pmid19912132">{{cite journal| author=Panebianco NL, Fredette JM, Szyld D, Sagalyn EB, Pines JM, Dean AJ| title=What you see (sonographically) is what you get: vein and patient characteristics associated with successful ultrasound-guided peripheral intravenous placement in patients with difficult access. | journal=Acad Emerg Med | year= 2009 | volume= 16 | issue= 12 | pages= 1298-303 | pmid=19912132 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=19912132 | doi=10.1111/j.1553-2712.2009.00520.x }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> Successful cannulation may occur with veins that are at least 0.6 cm in diameter and less than 1.6 cm in depth.<ref name="pmid19912132"/> | |||
==Complications== | ==Complications== | ||
| Line 5: | Line 12: | ||
===Infiltration=== | ===Infiltration=== | ||
The most common complication is infiltration of the intravenous infusion into the tissue surrounding the vein. This happens to approximately a third of catheterizations within 3 days.<ref name="pmid18483721">{{cite journal |author=Khalifa R, Dahyot-Fizelier C, Laksiri L, ''et al'' |title=Indwelling time and risk of colonization of peripheral arterial catheters in critically ill patients |journal=Intensive Care Med |volume=34 |issue=10 |pages=1820–6 |year=2008 |month=October |pmid=18483721 |doi=10.1007/s00134-008-1139-z |url=http://dx.doi.org/10.1007/s00134-008-1139-z |issn=}}</ref> This may be difficult to distinguish from phlebitis.<ref name="pmid1934920">{{cite journal |author=Wright A, Hecker J |title=Infusion failure caused by phlebitis and extravasation |journal=Clin Pharm |volume=10 |issue=8 |pages=630–4 |year=1991 |month=August |pmid=1934920 |doi= |url= |issn=}}</ref | The most common complication is infiltration of the intravenous infusion into the tissue surrounding the vein. This happens to approximately a third of catheterizations within 3 days.<ref name="pmid18483721">{{cite journal |author=Khalifa R, Dahyot-Fizelier C, Laksiri L, ''et al'' |title=Indwelling time and risk of colonization of peripheral arterial catheters in critically ill patients |journal=Intensive Care Med |volume=34 |issue=10 |pages=1820–6 |year=2008 |month=October |pmid=18483721 |doi=10.1007/s00134-008-1139-z |url=http://dx.doi.org/10.1007/s00134-008-1139-z |issn=}}</ref> This may be difficult to distinguish from phlebitis.<ref name="pmid1934920">{{cite journal |author=Wright A, Hecker J |title=Infusion failure caused by phlebitis and extravasation |journal=Clin Pharm |volume=10 |issue=8 |pages=630–4 |year=1991 |month=August |pmid=1934920 |doi= |url= |issn=}}</ref> | ||
===Bacterial colonization=== | ===Bacterial colonization=== | ||
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* 20–24 days is 6.0% | * 20–24 days is 6.0% | ||
* >24 days is 5.7% | * >24 days is 5.7% | ||
===Phlebitis=== | |||
Phlebitis occurs in approximately 3% of catheterizations within 3 days.<ref name="pmid18483721">{{cite journal |author=Khalifa R, Dahyot-Fizelier C, Laksiri L, ''et al'' |title=Indwelling time and risk of colonization of peripheral arterial catheters in critically ill patients |journal=Intensive Care Med |volume=34 |issue=10 |pages=1820–6 |year=2008 |month=October |pmid=18483721 |doi=10.1007/s00134-008-1139-z |url=http://dx.doi.org/10.1007/s00134-008-1139-z |issn=}}</ref> This may be difficult to distinguish from phlebitis.<ref name="pmid1934920">{{cite journal |author=Wright A, Hecker J |title=Infusion failure caused by phlebitis and extravasation |journal=Clin Pharm |volume=10 |issue=8 |pages=630–4 |year=1991 |month=August |pmid=1934920 |doi= |url= |issn=}}</ref> Phlebitis has been defined as "two or more of pain, tenderness, warmth, erythema, swelling, or a palpable cord."<ref name="pmid18483721"/> | |||
==Prevention of complications== | ==Prevention of complications== | ||
Routine replacement of peripheral catheterization every three days has similar complications to only replacing when complications occur.<ref name=" | Routine replacement of peripheral catheterization every three days has similar complications to only replacing when complications occur.<ref name="pmid20238356">{{cite journal| author=Webster J, Osborne S, Rickard C, Hall J| title=Clinically-indicated replacement versus routine replacement of peripheral venous catheters. | journal=Cochrane Database Syst Rev | year= 2010 | volume= 3 | issue= | pages= CD007798 | pmid=20238356 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=20238356 | doi=10.1002/14651858.CD007798.pub2 }} </ref><ref name="pmid18614482">{{cite journal |author=Webster J, Clarke S, Paterson D, ''et al'' |title=Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial |journal=BMJ |volume=337 |issue= |pages=a339 |year=2008 |pmid=18614482 |pmc=2483870 |doi= |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=18614482 |issn=}}</ref> | |||
==References== | ==References== | ||
<references/> | <references/>[[Category:Suggestion Bot Tag]] | ||
Latest revision as of 16:01, 2 October 2024
In medicine, peripheral catheterization is "insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes"[1] such as intravenous infusion of medications or fluid therapy. This is in contrast to central venous catheterization.
Equipment and procedure
Intravenous catheterization is most common. An area over a suitable vein is cleaned, and one of two types of catheter insertion devices is used. One uses a large-bore metal needle inside which is a plastic catheter, and the other uses a plastic catheter over a stiffening sharp metal core. Once in the vein, the metal device is removed, the catheter attached to the fluid delivery system, and a sterile adhesive dressing put over the puncture site, both to protect it from infection and to keep the catheter in place.
Ultrasonography may be used to guide catheterization.[2] Successful cannulation may occur with veins that are at least 0.6 cm in diameter and less than 1.6 cm in depth.[2]
Complications
Several complications can occur.[3]
Infiltration
The most common complication is infiltration of the intravenous infusion into the tissue surrounding the vein. This happens to approximately a third of catheterizations within 3 days.[4] This may be difficult to distinguish from phlebitis.[5]
Bacterial colonization
The rate of bacterial colonization is depending on duration of catheterization is:[4]
- 4 days is 1.0%
- 5–9 days is 1.9%
- 10–14 days 3.5%
- 15–19 days is 7.0%
- 20–24 days is 6.0%
- >24 days is 5.7%
Phlebitis
Phlebitis occurs in approximately 3% of catheterizations within 3 days.[4] This may be difficult to distinguish from phlebitis.[5] Phlebitis has been defined as "two or more of pain, tenderness, warmth, erythema, swelling, or a palpable cord."[4]
Prevention of complications
Routine replacement of peripheral catheterization every three days has similar complications to only replacing when complications occur.[6][7]
References
- ↑ Anonymous (2024), Peripheral catheterization (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 Panebianco NL, Fredette JM, Szyld D, Sagalyn EB, Pines JM, Dean AJ (2009). "What you see (sonographically) is what you get: vein and patient characteristics associated with successful ultrasound-guided peripheral intravenous placement in patients with difficult access.". Acad Emerg Med 16 (12): 1298-303. DOI:10.1111/j.1553-2712.2009.00520.x. PMID 19912132. Research Blogging.
- ↑ Bregenzer T, Conen D, Sakmann P, Widmer AF (January 1998). "Is routine replacement of peripheral intravenous catheters necessary?". Arch. Intern. Med. 158 (2): 151–6. PMID 9448553. [e]
- ↑ 4.0 4.1 4.2 4.3 Khalifa R, Dahyot-Fizelier C, Laksiri L, et al (October 2008). "Indwelling time and risk of colonization of peripheral arterial catheters in critically ill patients". Intensive Care Med 34 (10): 1820–6. DOI:10.1007/s00134-008-1139-z. PMID 18483721. Research Blogging.
- ↑ 5.0 5.1 Wright A, Hecker J (August 1991). "Infusion failure caused by phlebitis and extravasation". Clin Pharm 10 (8): 630–4. PMID 1934920. [e]
- ↑ Webster J, Osborne S, Rickard C, Hall J (2010). "Clinically-indicated replacement versus routine replacement of peripheral venous catheters.". Cochrane Database Syst Rev 3: CD007798. DOI:10.1002/14651858.CD007798.pub2. PMID 20238356. Research Blogging.
- ↑ Webster J, Clarke S, Paterson D, et al (2008). "Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial". BMJ 337: a339. PMID 18614482. PMC 2483870. [e]