An Evaluation of the Effectiveness of Local Anesthetics Used During Intravenous Catheter Insertion

Inclusion criteria

• adult patients (aged 18 or older)
• admitted to a general medical or surgical unit at Durham Regional Hospital (DRH)
• have a physician's order for an IV
• are able to speak, read and understand English
• referred to the Vascular Access Specialty Team (VAST) at DRH for IV catheterization

Exclusion criteria

• admission to the emergency room, pre-op unit, an outpatient unit, a psychiatric unit, an intensive care unit, a pre- or postnatal care unit, or labor and delivery units;
• history of a psychological disorder, as determined from the patient's chart;
• history of peripheral neuropathy, as determined by patient's chart;
• history of IV drug abuse, as determined from the patient's chart;
• decreased sensation in the arm or hands, as reported in the chart or by the patient;
• patient disorientation or confusion (i.e., unable to state person, place, time or unable to comprehend instructions for completing Visual Analog Scale);
• a known allergy to lidocaine or benzyl alcohol as determined from the patient's chart;
• veins that cannot be palpated and are difficult to visualize by VAST nurses;
• pregnancy;
• an order for the emergency insertion of an IV by the patient's doctor or assigned nurse;
• an IV insertion that requires the use of a catheter gauged 18 or larger
• severe vision impairment, as determined by the patient's inability to read the Visual Analogue Scale