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BRISBANE, AUSTRALIA – In a busy emergency department, reinserting peripheral intravenous devices (PIVs) is a time thief, especially since more than 1 in 10 of them simply fall out.
The solution, according to an Australian study recently published in Annals of Emergency Medicine? Medical-grade “super glue.”
Tissue adhesive, i.e. cyanoacrylate, is used for everything from closing skin lacerations and wounds as an alternative to sutures or staples to repairing gastric varices, inguinal hernias, bones, tendons, and retinal detachments.
A study team led by researchers from Caboolture Hospital and the University of Queensland conducted a single-site, two-arm, non-blinded, randomized, controlled trial of 380 peripheral intravenous catheters inserted into 360 adult patients.
While the control group received standard securement, a second group received standard securement in addition to cyanoacrylate skin glue applied to the skin insertion site.
The success of the intervention was determined by peripheral intravenous catheter failure at 48 hours, regardless of cause. The researchers also looked at individual modes of peripheral intravenous catheter failure, infection, phlebitis, occlusion or dislodgement.
Results indicate that peripheral intravenous catheter failure was 10% lower with skin glue (17%) than standard care (27%), and dislodgement was 7% lower. While rates of phlebitis and occlusion were lower with skin glue, the difference was not statistically significant. No infections were identified.
“This study supports the use of skin glue in addition to standard care to reduce peripheral intravenous catheter failure rates for adult emergency department patients admitted to the hospital,” study authors conclude.
An earlier study in Brisbane, which looked at PIV failure across the hospital setting, discussed the benefits of avoiding it, noting that “despite a high clinical need and the high costs to hospitals for products given the significant volume of use, there is a paucity of studies reporting the efficacy of alternative dressing and securement methods. Rigorous assessment of the efficacy and cost-effectiveness of PIV dressing and securement methods is therefore needed to guide clinical decision-making. If failure rates can be reduced by 10%, this would prevent more than 30 million PIV failures and reinsertions in the USA each year alone, with phenomenal associated reductions in health costs and nursing/medical time."