• Joshua Gentges, Annette Arthur, Tessa Stamile, and Michael Figureido.
• Evidence Based Medicine, Department of Emergency Medicine, Oklahoma University, Tulsa, Oklahoma; Department of Emergency Medicine, Oklahoma University, Tulsa, Oklahoma.
• J Emerg Med. 2016 Feb 1; 50 (2): 235-8.

BackgroundRising health care costs and increased scrutiny concerning spending have prompted providers and hospitals to identify unnecessary procedures and waste. Peripheral intravenous line (pIV) placement is one of the most common medical procedures performed. A recent study reported that 50% of intravenous lines placed in the emergency department (ED) went unused. If half of all pIVs placed in EDs systemically go unused, the costs and complications associated with pIV placement are unacceptably high.ObjectivesOur study aims to ascertain the frequency of pIV placement and usage in an urban ED.MethodsThis was a retrospective review of medical records for consecutive patients seen in an academic ED in June 2014. The following data points were recorded: age, sex, chief complaint, acuity level on admission, pIV placement both prehospital and in the ED, and pIV utilization (for fluids, medications, or contrast administration).ResultsThere were 509 charts reviewed, with a median patient age of 40 years. Common chief complaint categories included neurologic, cardiac, and skin/soft tissue. Triage acuity was varied, with a mean of 3.3. A pIV was placed in 55% of subjects. Prehospital providers placed 19%. Of all pIVs placed, 72% were used for the administration of medications, 19% for contrast, and 67% for fluids. Eighty-five percent of pIVs were used; 51% of patients with a pIV were admitted from the ED.ConclusionIn this study's ED, 85% of pIVs were used prior to discharge. Strategies to lower pIV placement rates should focus on alternative routes of medication and fluid administration.Copyright © 2016 Elsevier Inc. All rights reserved.

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