Course Access
Hi Rosie,
You are correct. The BD Venflon IV cannula has been widely used throughout
Europe and the UK (well it was when I was there many years ago). Is it the
Pro Safety or the standard ported cannula?
This style of ported cannula has been around since the early 1980’s, so
despite the recent addition of a safety aspect, it is still old technology
(in regards to the port aspect).
A ported cannula has significantly increased infection rates due to the
inability to correctly scrub the hub or decontaminate the injection port, as
well as port cap failure.
Here is an Australian publication from NT in 2013 that may help in product
purchase changes – Tay, S et al. Functional evaluation and practice survey
to guide purchasing of intravenous cannulae, BMC Anesthesiology 2013, 13:49
http://www.biomedcentral.com/1471-2253/13/49
There has also been reports from the UK of the ports failing – H. Adler, R.
Cunningham, R. Parimkayala Valve failure in an injection port, Irish Journal
of Medical Science June 2011, Volume 180, Issue 2, p 615
http://link.springer.com/article/10.1007/s11845-010-0622-z
These ported styles of cannula were likely introduced due to the higher
number of UK physicians coming to work in WA (possibly due to clinician
preference only) and have high infection and poor compliance rates, due to
the difficult nature of port location. These are primarily placed in OT only
(as you describe) and are not used in the general wards areas as far as I am
aware.
Although this may be a ‘convenient option’ for clinicians, it is not in the
best interest of the patient, due to the higher risks associated with these
types of cannulae.
From the BD Europe website;
http://www.bd.com/europe/safety/en/products/infusion/bdv_prosafety.asp
* BD VialonT – Proven easy insertion and longer in dwell times1-4
1) Maki D, Ringer M. Risk Factors for Infusion-related Phlebitis with
Small Peripheral Venous Catheters. Annals of Internal Medicine. (1991); 114:
845-854.
2) Gaukroger PB, Roberts JG, Manners TA. Infusion Thrombophlebitis: A
Prospective Comparison of 645 VialonR and TeflonR Canulae in Anesthetic and
Postoperative Use. Anesthesia and Intensive Care.August (1988); 16(3).
3) Stanley M, Meister E, Fuschuber K. Infiltration During Intravenous
Therapy in Neonates: Comparison of TeflonR and VialonR Catheters. Southern
Medical Journal.September (1992); 85(9); 883-886.
4) McKee JM, Shell JA, Warren TA, Campbell VP. Complications of
Intravenous Therapy: A Randomized Prospective Study–Vialon vs. Teflon.
Journal of Infusion Nursing. September (1989); 12: 288-2.
Considering the ongoing changes in technology and increased focus on device
and patient outcomes, these references are very old and dated. I agree with
you that this as a huge risk for contamination and a breach of AT
principles.
The BD Nexiva cannula would seem to be a far better alternative (for patient
and clinician), and still offering a safety option, various access points
and improved securement.
Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert, VA-BC.
Independent Vascular Access Consultant
President, Australian Vascular Access Society
Conjoint Lecturer, South West Sydney Clinical School | Faculty of Medicine |
University of NSW
Director-at-Large, Vascular Access Certification Corporation (VACC)
Representative – WoCoVA Global Strategic Committee
M: +1 (623) 326 8889 (USA)
M: +61 (0)409 463 428 (AU)
E: tim.spencer68@icloud.com
“Be a yardstick of quality. Some people aren’t used to an environment where
excellence is expected.” – Steve Jobs
Of Lee, Rosie
Hello
Recently I have been made aware of this practice following implementation of
Aseptic Technique Policy. It appears in our theatres the Anaesthetists use
the BD VenflonT intravenous catheter with integrated injection port and
valve for medication and this stays in the patient. I am told the caps are
either being left open in Theatres for quick access by Anaesthetists or they
popp off very frequently. In recovery nurses are observed continuing to use
this to administer medication. I see this as a huge risk for contamination
and a breach of AT principles.
The BD representative states that this type of catheter is not used in other
states of Australia but is common in UK and Europe. Is this correct?
Have you come across this in your hospitals? If so have you ceased the use
or do you advocate using the side extension tubing which has a hub that can
be scrubbed?
Regards
Rosie Lee | Coordinator | Infection Prevention & Management
Royal Perth Hospital
Level 6, South Block, Wellington Street PERTH WA 6000
T: (08) 9224 2805 | F: (08) 9224 1989
E: rosie.lee@health.wa.gov.au
http://www.rph.health.wa.gov.au |
http://www.healthywa.wa.gov.au
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