Peripheral Iintravenous cannula usage in the Emergency Department


Over a billion Peripheral Intra-Venous Cannulas (PIVC) are used globally every year with at least 25 million sold annually in the UK.1,2 The NHS spends an estimated £29m of its annual acute sector budget on PIVC procurement3 and around 70% of all hospitalised patients require at least one PIVC during their stay.4 Despite their extensive and routine use, PIVC failure rates are reported as high as 50-69%.5-7 In addition, many PIVCs remain unused following insertion, particularly in the Emergency Department (ED).8,9 The risk factors for PIVC failure are not well understood and the literature has found extensive regional variation in practice when it comes to PIVC insertion and management.1,7,10 While various technologies have been developed to address these issues, there remains a need for standardised, evidence-based guidelines.



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Alexandrou E, Ray-Barruel G, Carr PJ, Frost S, Inwood S, Higgins N, et al. International prevalence of the use of peripheral intravenous catheters, J Hosp Med. 2015 Aug;10(8):530-3 DOI:

NHS Clinical Evaluation Team. Clinical review: safety peripheral intravenous cannula. 2018.

Guerrero MA. National evaluation of safety peripheral intravenous catheters in a clinician-led project. Br J Nurs. 2019 Jan 24;28(2):S29-32. DOI:

Webster J, Clarke S, Paterson D, Hutton A, Dyk S, Gale C et al. Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial. BMJ. 2008;337(jul08 1):a339-a339. DOI:

Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but Unacceptable. J Infus Nurs. 2015;38(3):189-203. DOI:

Marsh N, Webster J, Larsen E, Cooke M, Mihala G, Rickard CM. Observational Study of Peripheral Intravenous Catheter Outcomes in Adult Hospitalized Patients: A Multivariable Analysis of Peripheral Intravenous Catheter Failure. J Hosp Med. 2017 Oct 18. DOI:

Alexandrou E, Ray-Barruel G, Carr PJ, Frost SA, Inwood S, Higgins N, et al. Use of Short Peripheral Intravenous Catheters: Characteristics, Management, and Outcomes Worldwide. J Hosp Med. 2018 May 30;13(5). DOI:

Limm EI, Fang X, Dendle C, Stuart RL, Egerton Warburton D. Half of All Peripheral Intravenous Lines in an Australian Tertiary Emergency Department Are Unused: Pain With No Gain? Ann Emerg Med. 2013 Nov;62(5):521-5. DOI:

Gledstone-Brown L, McHugh D. Review article: Idle ‘just-in-case’ peripheral intravenous cannulas in the emergency department: Is something wrong? Emerg Med Australas. 2018 Jun;30(3):309-26. DOI:

Webster J, Osborne S, Rickard C, Marsh N. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database of Systematic Reviews. 2019. DOI:

Brief Reports
Peripheral intravenous cannula, failure rate, emergency department
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How to Cite
Stanley, A. K., Barnett-Vanes, A., & Reed, M. J. (2020). Peripheral Iintravenous cannula usage in the Emergency Department. Emergency Care Journal, 16(3).