A scoping review of randomised controlled trials in vascular access devices in emergency departments.

Abstract

Aims: To synthesise findings from randomised controlled trials (RCTs) on vascular access devices (VADs) in emergency departments (EDs).

Background: VADs play a critical role in EDs, enabling rapid delivery of supportive therapies to address urgent medical needs. This scoping review will map current evidence and determine areas to focus future research priorities.

Methods: Following Arksey and O'Malley's scoping review framework, a comprehensive search was conducted (2012-2024) across four databases. RCTs that focused on peripheral intravenous catheters, central venous catheters, arterial catheters, or intraosseous catheters in an ED setting were included.

Results: 48 RCTs were included, a majority focused on peripheral intravenous catheters (n = 41, 85 %), followed by central venous catheters (n = 4, 8 %), arterial catheters (n = 2, 4 %), and intraosseous catheters (n = 1, 3 %). The findings were categorised by intervention type, including vessel visualisation technology, catheter design, dressing and securement design, distraction techniques, topical anaesthetics, inserter models, and other related techniques. The top three most frequently reported outcomes were insertion success (n = 21), time to successful insertion (n = 20), and catheter-related complications (n = 19).

Conclusion: This review provides ED clinicians with current evidence on VAD technologies and techniques, enabling them to select and implement the most effective options into daily practice reduce costs and improve patient satisfaction.