Peripheral line dead space: an unrecognised phenomenon?

OBJECTIVE To determine if peripheral intravenous cannula dead space is taken into account when setting up intravenous infusions (in particular nitrate infusions) in the emergency department. METHOD A postal survey of UK emergency departments. RESULTS Of the 143 (58%) of UK departments who responded, only 15% reported priming the cannula before commencing the nitrate infusion. CONCLUSIONS Knowledge of peripheral intravenous cannula dead space in UK emergency departments is very poor and, as a result, there is probably significant widespread under treatment of patients in severe cardiogenic pulmonary oedema. Departments should amend their treatment guidelines to take account of peripheral cannula dead space.