Incidence of complications of peripheral intravenous cannula use in children admitted to Port Moresby general hospital: A prospective, observational study

Abstract

Peripheral intravenous cannulas (PIVCs) are used for administration of medications and fluids in sick children but their use can result in complications. This prospective study was conducted from June to October 2020 at Port Moresby General Hospital in Papua New Guinea. Children who were admitted to the paediatric wards requiring PIVC insertion were regularly monitored to check for complications. Three hundred and thirty PIVCs were inserted in 104 paediatric patients. Eighty six (83%) of the 104 children had at least one PIVC complication which occurred in 220 (67%) of the 330 PIVCs assessed. Tissue infiltration was the commonest complication, occurring in 60% of the PIVCs, followed by phlebitis (29%), cannula obstruction (6%) and leaking (4%). Skin ulceration occurred in 1%. Larger gauge cannulas were more than twice as likely to be associated with complications as smaller gauge cannulas and administration of both medications and fluids more likely to result in complications than administration of medications alone. The incidence of PIVC complications of 83% by patient and 67% by cannula is of major concern. Staff should be aware of the risks associated with PIVC, ensure that PIVS are carefully inserted and stabilized and regularly monitored to prevent, detect and manage complications appropriately.