Evaluation of the Efficiency of the Newly Developed Needle in Emergency Room: A Single-Center Observational Study

TL;DR

A new needle was tested in an emergency room to see if it reduced failed intravenous catheter insertions, but no significant improvement was found compared to the old needle.

Contribution

This study evaluates the effectiveness of a newly developed needle for peripheral intravascular catheter insertion in an emergency room setting.

Findings

The new needle did not significantly reduce initial PIVC insertion failure compared to the existing needle.

There was no significant difference in the number of procedures between the two needle types.

Multivariate analyses showed no association between the new needle and improved outcomes.

Abstract

Peripheral intravascular catheter (PIVC) insertion is frequently performed in the emergency room (ER) and many failures of initial PIVC insertion occur. To reduce the failures, new needles were developed. This study aimed to investigate whether the use of the newly developed needle reduced the failure of initial PIVC insertion in the ER compared with the use of the existing needle.

This single-centre, prospective observational study was conducted in Japan between April 1, 2022, and February 2, 2023. We included consecutive patients who visited our hospital by ambulance as a secondary emergency on a weekday during the day shift (from 8:00 AM to 5:00 PM). The practitioners for PIVC insertion and assessors were independent. The primary and secondary outcomes were the failure of initial PIVC insertion and number of procedures, respectively. We defined the difficulty of titrating, leakage, and hematoma within 30 s after insertion as failures. To evaluate the association between the outcomes and the use of newly developed needles, we performed multivariate logistic regression and multiple regression analyses by adjusting for covariates.

In total, 522 patients without missing data were analysed, and 81 (15.5%) patients showed failure of initial PIVC insertion. The median number of procedures (interquartile range) was 1 (1–1). Multivariate logistic regression analysis revealed no significant association between the use of newly developed PIVCs and the failure of initial PIVC insertion (odds ratio, 0.79; 95% confidence interval, [0.48–1.31]; p = 0.36). Moreover, multiple regression analysis revealed no significant association between the use of newly developed PIVCs and the number of procedures (regression coefficient, −0.0042; 95% confidence interval, [−0.065–0.056]; p = 0.89).

Our study did not show a difference between the two types of needles with respect to the failure of initial PIVC insertion and the number of procedures.

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