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Table 1 List of appropriate indications

From: De-implementation strategy to Reduce the Inappropriate use of urinary and intravenous CATheters: study protocol for the RICAT-study

Urinary catheter Peripheral intravenous catheter Central intravenous catheter
Acute urinary retention or bladder outlet obstruction (≥150 cc) Delivery of peripherally compatible infusate (IV fluids and medications), at least once in 24 h Delivery of non-peripherally compatible infusate (e.g., irritants or vesicants), regardless of proposed duration of use
Accurate measurements of urinary output in critically ill patients required for treatment Transfusion of blood and blood products PICC : delivery of peripherally compatible infusate, with a duration of use which will likely confine ≥ 6 daysb
Volume measurements of urine output aim for diagnostics (24 h urine), which cannot be assessed by other collection strategies Injection of contrast fluids Invasive hemodynamic monitoring or requirement to obtain central venous access in critically ill patients
-Nontunneled CVC : duration of use will likely confine < 15 days
-PICC : duration of use will likely confine ≥ 15 days
Assist in healing of open sacral or perineal wounds in patients with urinary incontinence Intravenous access for cardiac dysrhythmia PICC : Delivery of cyclical or episodic chemotherapy that can be administered through a peripheral vein, provided that the proposed duration of such treatment is ≥3 months
Continuous bladder irrigation for hematuria PIVC : duration of use will likely confine ≤ 5 days Frequent phlebotomy (every 8 h), provided that the proposed duration of such use is ≥6 days
Patient requires prolonged immobilization Midline : duration of use will likely confine ≤ 14 daysa PICC : Intermittent infusions or infrequent phlebotomy in patients with poor/difficult peripheral venous access, provided that the proposed duration of such use is ≥ 6 days
Palliative care for terminally ill if needed   PICC: For infusions or palliative treatment during end-of-life care
Pre- or postoperative according (local) protocol   Tunneled catheter or port : preferred if proposed duration is ≥ 31 day
  1. aUse of PIVCs is preferred over use of midlines for infusion of peripherally compatible infusates up to 5 days
  2. bUse of PIVCs or midlines is preferred over use of PICCs for infusion of peripherally compatible infusates up to 14 days