Single Lumen Midline Catheter Vs Long Peripheral Intravenous Cather for Difficult Intravenous Access in the ED

Launched by ALBANY MEDICAL COLLEGE · Oct 30, 2024

Keywords

ClinConnect Summary

This clinical trial is studying which type of catheter works better for patients in the emergency department who have difficult veins for getting an intravenous (IV) line. When patients need medications but their veins are hard to access, healthcare providers can use either a 2-inch long IV catheter or a 4-inch midline catheter. The trial will help determine if one of these catheters is more effective for these patients.

To be eligible for the study, participants must be adults aged 18 and older who have experienced difficulty in getting an IV line, such as having two failed attempts or a history of needing multiple attempts in the past. During the trial, participants will have either the 2-inch or the 4-inch catheter placed in a safe and controlled environment. This research is important as it could improve how healthcare providers access veins in patients who face challenges with traditional IV methods. If you think you might qualify or have questions, please talk to your healthcare provider.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• * Adult (age 18 and older) patients presenting to the AMC ED with difficult IV access defined as any of the following:
• • Two failed attempts at landmark based IV or US-guided peripheral vascular access by qualified ED staff
• * Self-reported history of difficult IV access and one of the following:
• • History of requiring 2 or more IV attempts on a previous visit (either self-reported or documented in the electronic medical record)
• * Previous requirement for a rescue device after failed IV access attempt. These devices are as follows:
• • US guided PIV
• • Midline catheter
• • Peripherally inserted central catheter
• • Central venous catheter
• • Intraosseous catheter
• • History of or active comorbid disease state with known difficult IV access
• • Prior or current implanted port device
• • End stage renal disease with fistula
• • Sickle cell disease
• • History of or active intravenous drug use
• Exclusion Criteria:
• • Patients under the age of 18
• • Known Prisoners
• • Non-English-speaking patients
• • Patients in whom the device cannot be stabilized due to tissue or treatments in bilateral extremities or available extremity (burns, complex humeral fractures, dialysis fistulas etc.)
• • Patients lacking capacity to consent
• • Patients unable to sign written consent
• • Patients without identifiable target veins by ultrasonography
• • Known pregnant patients
• • Previously enrolled in this study
• • Previously withdrawn from this study
• • Presented when no study IV proceduralists are available
• • Patients in whom obtaining informed consent and being enrolled in the study would put them at risk for obtaining time sensitive medical care