First-attempt insertion success: PIVCs with notched vs non-notched needles

Vascular access devices are widely used in hospitals, given that 60–90% of patients admitted receive a vascular access device (VAD).1 Peripheral intravenous (IV) catheterisation is not only the most preferred method of vascular access in non-emergency situations but also the most commonly performed emergency procedure.2 

In clinical practice, the IV catheter is inserted through the skin and advanced till a flashback of blood is observed by the practitioner. In most current catheters, the blood must flow through the entire length of the needle before the flashback can be seen. Continuing to advance the needle during this critical millisecond time scale may result in the risk of the needle traversing through the opposite wall of the vein.2 

The use of a notched needle is thought to improve cannulation success by confirming vein entry at the point of insertion with the immediate flashback of the blood.3 Notched needles have a series of carved notches on their shaft.4 

References

1 1. Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs 2015; 38(3): 189-203. DOI: 10.1097/NAN.0000000000000100 

 2 van Loon FH, Timmerman R, den Brok GP, Korsten EH, Dierick-van Daele AT, Bouwman AR. The impact of a notched peripheral intravenous catheter on the first attempt success rate in hospitalized adults: Block-randomized trial. J Vasc Access. 2021 Feb 2:1129729821990217. doi: 10.1177/1129729821990217. 

 3 Strauss KW, Onia R, Van Zundert AA. Peripheral intravenous catheter use in Europe: towards the use of safety devices. Acta Anaesthesiol Scand. 2008 Jul;52(6):798-804. doi: 10.1111/j.1399-6576.2008.01664.x.

Approval number : BD-56861

 4 Khadem M, Rossa C, Usmani N, Sloboda RS, Tavakoli M. Introducing Notched Flexible Needles with Increased Deflection Curvature in Soft tissue. 2016 IEEE International Conference on Advanced Intelligent Mechatronics (AIM); 12–15 July 2016; Banff, Alberta, Canada. DOI: 10.1109/AIM.2016.7576931 

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