IV cannula use on disposition of Emergency Department patients

Miss Rebekah Bernoth1
1John Flynn Hospital, Tugun, Australia

Peripheral intravenous cannulas are inserted in emergency departments at a high volume. There are various uses for these cannulas, including pathology collection, pain relief, medication administration and intravenous fluid therapy while in the Emergency Department (ED). When a patient is transferred to the ward from the ED the IV cannula is left intact though it may not be utilised as part of care on the ward. The issue examined in this research study is whether this practice increases the risk for infection or trauma to the site of insertion and whether the cannula should be removed at the end of the emergency stay before being discharged to the ward. Our objective is to safely manage our patients treatment and do this by reducing the risk of infection.

Methodology: We have studied 240 random peripheral intravenous cannula insertions from one private ED over a 12 month period. This retrospective qualitative research collected data regarding the insertion at the ED, the use of the cannula in ED, the usage of the cannula on the ward post discharge from ED, infection at site and the removal time of the cannula.
Results: The findings in this data is that over 50% of patients who are sent to the ward with a cannula inserted did not have their cannula used for any treatment and therapy of any sort. Over 60% of the cannulas that were not used on the ward remained insitu for 48 or more hours.
Implications: The results of this study leads to the further discussion on whether IV cannulas should be removed at the end of the ED stay in order to reduce the potential for infection as well as removing the task of the ward nurses flushing the cannula, redressing the site and documentation according to the hospital policy on management of the IV cannula.


Rebekah Bernoth is a clinical nurse at John Flynn Hospital Emergency Department. Rebekah has been a nurse for 17 years and in that time practised in a wide scope of nursing including medical, surgical, pain management and speaking at overseas conferences before spending many years in Intensive Care and now in an Emergency Department. She is an academic tutor at Southern Cross University, facilitates TAFE and university students in hospital settings. Rebekah has spent most of her years post graduating from Bachelor of Nursing furthering her education and is currently in the middle of her second Masters in Emergency Nursing. She enjoys the study and keeping up with the every changing nursing practises and new therapies with the drive to not stop studying and learning. She is an advocate for the innovation of best-evidence practise to promote better outcomes for patients and staff satisfaction. Rebekah has had a passion for nursing since a young age of 6yrs and never considered another career. Rebekah believes in the quote “When you’re a nurse you know that every day you will touch a life or a life will touch yours”, proving to be true with many experiences and challenges over her nursing career.