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To splint or not to splint?
It has been my own experience, and I have observed it in others, that the amount of energy devoted to fixing an intravenous cannula is proportional to the difficulty of inserting it. So when a cannula is inserted in a vein such that it crosses a joint, it has been usual practice in many places to try to prevent movement of the cannula by splinting the limb, with the intention of prolonging its life. But does this work? Not according to Dalal et al, who randomised cannula insertions to ‘splint’ or ‘no splint’ and found no difference in the lifespan of the cannula. I can already hear the anguished dissent as everyone who ‘knows’ how important splints are insists that this cannot be true for cannulas in the foot/hand/antecubital fossa/popliteal fossa (select your preference). It is now up to anyone who believes that splinting is still appropriate for some specific location to prove it themselves—with an RCT, of course. See page F394
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