Intended for healthcare professionals


Improving the safety of peripheral intravenous catheters

BMJ 2008; 337 doi: (Published 08 July 2008) Cite this as: BMJ 2008;337:a630
  1. Dennis G Maki, professor of medicine and hospital epidemiologist
  1. 1Section of Infectious Diseases, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
  1. dgmaki{at}

    Specialised teams and technology could bring greater benefit than routine replacement

    Current guidelines from the United Kingdom1 and Australia2 recommend routine replacement of peripheral intravenous catheters every 48-72 hours to prevent painful infusion phlebitis and rare but life threatening peripheral catheter related bacteraemia. In the United States, Centers for Disease Control and Prevention guidelines recommend replacement every 72-96 hours.3 However, numerous large prospective cohort studies4 5 6 7 8 provide convincing evidence that the risk of bacteraemia associated with the small Teflon or polyetherurethane catheters now widely used in hospitals is only about 0.1-0.3 per 100 catheters.9 10 Because many hospitals do not have a team of nurses responsible for the insertion and care of peripheral intravenous catheters, and the average duration of catheterisation rarely exceeds three to four days, many hospitals no longer routinely replace catheters at defined intervals.

    In the linked study (doi: 10.1136/bmj.a630), Webster and colleagues report a large randomised controlled trial of different methods of managing peripheral intravenous catheters,11 following …

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