Preventing infusate injuries throughout a child’s hospitalisation

The IV biosensor (ivWatch® sensor applied within 10–15mm of the peripheral intravenous catheter (PIVC) tip) plus standard clinical observation to detect extravasations and prevent extravasation injury. The IV biosensor device consists of: 1. A patient monitor with audible alarm, 2. An optical sensor cable, and, 3. A sterile, disposable receptacle for attaching the sensor to the patient’s skin, near the PIVC site The IV biosensor involves the blue sensor being placed over tissue / polyurethane dressing next to the vein between the intravenous (IV) insertion site and the IV tip (normally around 5-10mm from the insertion site) and plugged into the monitor. Once applied, this sensor stays in situ until study end (i.e. IV removal or discharge from study hospital), unless the infant needs magnetic resonance imaging (MRI; due to metal in the sensor) or other treatments which are incompatible with the IV biosensor. The IV biosensor is to be applied on the day of enrolment for both newly inserted PIVCs and existing PIVCs. The IV biosensor will be applied by member of the research team (a Clinical Research Nurse), and monitored hourly by the patient’s bedside nurse throughout the course of their admission or until their PIVC is removed. The patient’s bedside nurse will also continue to monitor the PIVC site hourly for signs of extravasation (per usual, standard clinical practice) in addition to monitoring the IV biosensor patient monitor. All other aspects of PIVC insertion, management and removal will be standardised in accordance with the hospital site’s clinical practice guidelines. Insertion, maintenance and removal will be performed by the usual interdisciplinary staff. The Clinical Research Nurse will monitor and record adherence to the protocol during a daily check. The IV biosensor uses near infra-red light to continuously monitor the fluid pathway and surrounding tissue for early signs of extravasation. When fluid accumulates in the subcutaneous tissues, there is a significant change in the light scattering, which is recognised by the IV biosensor sensor and results in a “YELLOW CHECK IV” notification on the patient monitor, indicating the possibility of extravasation. If the infusion continues and the light signal further drops below the threshold, the patient monitor will return a “RED CHECK IV” notification, indicating probable extravasation.