Abstract
Introduction
Previous studies have identified obesity as a risk factor for difficult IV access,
but this has not been studied in the acute trauma setting. The primary objective was
to determine if obesity is associated with increased difficulty placing peripheral
IVs in trauma patients. Secondary analysis evaluated IV difficulty and associations
with nursing self-competence ratings, trauma experience, and patient demographics.
Methods
Prospective, observational study at academic level I trauma center with 58,000 annual
visits. Trauma activation patients between January and October of 2016 were included.
Each nurse who attempted IV placement, completed anonymous 7 question survey, including
trauma experience (years), self-competence and IV difficulty (Likert scales 1–5),
and attempts. Demographic and clinical information was retrospectively collected from
the EMR and nursing surveys. Descriptive statistics, chi-square tests, and spearman
correlations were used.
Results
200 patients included in the study with 185 BMI calculations. 110 overweight (BMI > 25)
and 48 obese (BMI > 30). 70 (35%) female, 149 (75%) white, average age 48. Increased
BMI and IV difficulty displayed spearman correlation (ρ) of 0.026 (P = 0.72) suggesting
against significant association. Increased trauma experience and self-competence ratings
significantly correlated with decreased IV difficulty, ρ = −0.173 and −0.162 (P = 0.010
and 0.014). There was no statistically significant association with IV difficulty
in regards to patient race, age, sex, or location of IV placement.
Conclusion
Obesity was not associated with increased difficulty in placing peripheral IVs in
trauma activation patients. Nurses with greater trauma experience and higher self-competence
ratings, had less difficulty inserting IVs.
Keywords
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Article Info
Publication History
Published online: May 15, 2020
Accepted:
May 11,
2020
Received in revised form:
May 4,
2020
Received:
April 1,
2020
Footnotes
☆Lightning Oral Presentation: Society of Academic Emergency Medicine (SAEM) Annual Meeting, Orlando, FL, May 19, 2017.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
