Monthly Archives: November 2013

What is the evidence behind recommended syringe size in pushing medications through IVs?

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No relevant references were identified in searches of Joanna Briggs, PubMed and CINAHL for combinations of these terms:
Iv push, Infusion, Catheter
Complications, adverse effects, adverse events, rupture
Syringe
Size, diameter

A search on Google revealed a discussion board on your topic.
http://allnurses.com/infusion-nursing-intravenous/question-about-piccs-241871-page3.html

There was a reference in the discussion board to this article:
Catheter Connection Column. Journal of Vascular Access Devices. Volume 3 No 3,  Fall 1998

A cited reference search on this reference in CINAHL identified two papers that cite the it:
Douglas L, et al.  Central venous access devices: review of practice.  Paediatric Nursing, 2009 Jun; 21 (5): 19-22.

Dougherty L.  Central venous access devices.  Nursing Standard, 2000 Jul 12-18; 14 (43): 45-50, 53-4.

jkn March 2014

Is use of a secondary IV, or piggyback system, reduce the rate of central line-associated bloodstream infections?

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A search of Joanna Briggs for the term piggyback identified several evidence summaries and recommendations.  Each of them cited the 2002 CDC guidelines as evidence in discussing piggyback systems.

MMWR Recomm Rep. 2002 Aug 9;51(RR-10):1-29.
O’Grady NP, et al.  Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention.

On p. 11, the guidelines state that “modified piggyback systems have the potential to prevent contamination…” and cite this single study:

JPEN J Parenter Enteral Nutr. 1992 Nov-Dec;16(6):581-5.
Inoue Y, et al.  Prevention of catheter-related sepsis during parenteral nutrition: effect of a new connection device.

A search of PubMed was conducted using the following terms:
(piggyback OR secondary iv OR (secondary AND infusion)) AND infections AND prevention AND central venous catheters

The results include the Inoue study.  No other studies focus on prevention of catheter-associated bloodstream infections, but may report data on infection rates, which may also be useful.  However, the populations for most of the other studies were neonates.

jkn 3/14