scholarly journals PMD31 Efficacy, Safety and Efficiency Indicators in the Peripheral Venous Access Management

2020 ◽  
Vol 23 ◽  
pp. S581
Author(s):  
F. Schettini ◽  
L.B. Ferrario ◽  
E. Foglia ◽  
E. Garagiola ◽  
E. Porazzi ◽  
...  
Keyword(s):  
Venous Access ◽  
Access Management ◽  
Peripheral Venous Access ◽  
Efficiency Indicators

Ultrasound‐based criteria for adequate peripheral venous access in therapeutic apheresis procedures

2021 ◽  
Author(s):  
Eric Salazar ◽  
Faaria Gowani ◽  
Francisco Segura ◽  
Heather Passe ◽  
Lamesha Seamster ◽  
...  
Keyword(s):  
Venous Access ◽  
Peripheral Venous Access

scholarly journals Peripheral Inotropes in Critically Ill Children: Is It Safe?

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110222
Author(s):  
Ravi K. Mooli ◽  
Kalaimaran Sadasivam
Keyword(s):  
Central Venous Access ◽  
Pediatric Intensive Care ◽  
Venous Access ◽  
Critically Ill Children ◽  
Middle Income ◽  
Central Lines ◽  
Middle Income Countries ◽  
Peripheral Venous Access ◽  
Vasoactive Medications

Many children needing pediatric intensive care units care require inotropes, which are started peripherally prior to securing a central venous access. However, many hospitals in low- and middle-income countries (LMIC) may not have access to central lines and the vasoactive medications are frequently given through a peripheral venous access. Aim: The aim of our study was to describe the role of peripheral vasoactive inotropes in children. Methods: Children requiring peripheral vasoactive medications were included in this study. We retrospectively collected data at 2 time points on use and complications of peripheral vasoactive medications. Results: Eighty-four children (51 pre-COVID era and 33 COVID pandemic) received peripheral vasoactive medications. Only 3% of children (3/84) developed extravasation injury, all of whom recovered completely. Conclusions: Results from our study suggest that extravasation injury due to peripheral inotrope infusion is very low (3%) and it may be safely administered in children at a diluted concentration.

scholarly journals Parada cardiorrespiratória pré-hospitalar: avaliação dos atendimentos segundo o utstein style*

2019 ◽  
Vol 13 ◽  
Author(s):  
Robson Cristiano Zandomenighi ◽  
Eleine Aparecida Penha Martins
Keyword(s):  
Life Support ◽  
Cardiopulmonary Arrest ◽  
Advanced Life Support ◽  
Venous Access ◽  
Orotracheal Intubation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Epinephrine Administration ◽  
Peripheral Venous Access ◽  
Utstein Style

Objetivo: analisar as ocorrências, respostas e desfechos da parada cardiorrespiratória pré-hospitalar segundo o Utstein Style e identificar os fatores associados à sobrevida. Método: trata-se de um estudo quantitativo, documental e transversal, com vítimas de parada cardiorrespiratória atendidas nas unidades de suporte avançado de vida, no ano de 2015. Coletaram-se os dados a partir dos relatórios de atendimento do socorrista, organizando-os e analisando-os de acordo com o Utstein Style. Apresentaram-se os resultados em forma de tabelas. Resultados: verificaram-se 163 atendimentos, predominando o sexo masculino, não havendo associação entre idade e os desfechos. Identificou-se a maioria das PCRs como sendo de causa clínica, na residência e em assistolia, sendo entubação orotraqueal, acesso venoso periférico e administração de adrenalina os procedimentos mais frequentes. Constatou-se que as ocorrências presenciadas por espectadores leigos e o tempo-resposta da ambulância demonstraram uma associação com o desfecho sobrevida. Calculou-se a taxa de sobrevida em 25,1%. Conclusão: avaliou-se o serviço por meio da análise das ocorrências segundo o Utstein Style e verificaram-se associações entre o desfecho e as lacunas no atendimento, havendo a necessidade de intervenções em cada elo da corrente de sobrevivência. Descritores: Parada Cardíaca Extra-Hospitalar; Ressuscitação Cardiopulmonar; Serviços Médicos de Emergência; Ambulâncias; Emergências; Avaliação de Resultados. ABSTRACTObjective: to analyze the occurrences, responses and outcomes of prehospital cardiopulmonary arrest according to Utstein Style and to identify factors associated with survival. Method: this is a quantitative, documentary and cross-sectional study with victims of cardiopulmonary arrest treated at the advanced life support units in 2015. Data were collected from the rescuer's care reports and organized. and analyzing them according to Utstein Style. Results were presented in tables. Results: 163 cases were observed, predominantly male, with no association between age and outcomes. Most CRPs were identified as being of clinical cause, at home and in asystole, with orotracheal intubation, peripheral venous access and epinephrine administration being the most frequent procedures. It was found that the occurrences witnessed by lay spectators and the ambulance response time demonstrated an association with the survival outcome. The survival rate was calculated at 25.1%. Conclusion: the service was evaluated by analyzing the occurrences according to the Utstein Style and there were associations between the outcome and the gaps in care, requiring interventions in each link of the survival chain. Descriptors:  Out-of-Hospital Cardiac Arrest; Cardiopulmonary Resuscitation; Emergency Medical Services; Ambulances; Emergencies; Outcome Assessment. RESUMENObjetivo: analizar las ocurrencias, las respuestas y los resultados del paro cardiopulmonar prehospitalario según el Utstein Style e identificar los factores asociados con la supervivencia. Método: este es un estudio cuantitativo, documental y transversal con víctimas de paro cardiopulmonar tratadas en las unidades de soporte vital avanzado en 2015. Los datos se recopilaron de los informes de atención del rescatista, organizándolos y analizándolos según el Utstein Style. Los resultados se presentaron en tablas. Resultados: se observaron 163 casos, predominantemente masculinos, sin asociación entre la edad y los resultados. La mayoría de las PCRs se identificaron como de causa clínica, en el hogar y en la asistolia, siendo los procedimientos más frecuentes la intubación orotraqueal, el acceso venoso periférico y la administración de adrenalina los procedimientos más frecuentes. Se descubrió que las ocurrencias presenciadas por espectadores legos y el tiempo de respuesta de la ambulancia demostraron una asociación con el resultado de supervivencia. La tasa de supervivencia se calculó en 25.1%. Conclusión: el servicio se evaluó analizando las ocurrencias según el Utstein Style y hubo asociaciones entre el resultado y las brechas en la atención, lo que requiere intervenciones en cada eslabón de la cadena de supervivencia. Descriptores: Paro Cardíaco Extra-Hospitalario; Reanimación Cardiopulmonar; Servicios Médicos de Urgencia; Ambulancias, Urgencias Médicas, Evaluación de Resultado. 

scholarly journals PERIPHERAL INOTROPES IN CRITICALLY ILL CHILDREN - IS IT SAFE?

2021 ◽  
Author(s):  
Ravi K Mooli ◽  
K Sadasivam
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Critically Ill Children ◽  
Central Venous ◽  
Middle Income ◽  
Central Lines ◽  
Middle Income Countries ◽  
Peripheral Venous Access ◽  
Vasoactive Medications ◽  
Paediatric Intensive Care Units

ABSTRACTMany children needing paediatric intensive care units care require inotropes, which are started peripherally prior to securing a central venous access. However, many hospitals in low- and middle-income countries may not have access to central lines and the vasoactive medications are frequently given through a peripheral venous access.AimThe aim of our study was to estimate the safety of peripheral vasoactive inotropes in children.MethodsChildren requiring peripheral vasoactive medications were included in this study. We retrospectively collected data at two time points on use and complications of peripheral vasoactive medications.ResultsEighty-four children (51 pre-COVID era and 33 COVID pandemic) received peripheral vasoactive medications. Only 3% of children (3/84) developed extravasation injury, all of whom recovered completely.ConclusionsResults from our study suggest that extravasation injury due to peripheral inotrope infusion is very low (3%) and it can be safely administered in children at a diluted concentration.

scholarly journals Centrifugal and Membrane Therapeutic Plasma Exchange – A Mini-review

2018 ◽  
Vol 14 (2) ◽  
pp. 105 ◽  
Author(s):  
Michiel Etienne Janssens ◽  
Stuart Wakelin ◽  
◽  
Keyword(s):  
Plasma Exchange ◽  
Membrane Filtration ◽  
Venous Access ◽  
Therapeutic Plasma Exchange ◽  
Performance Parameters ◽  
Procedure Time ◽  
Peripheral Venous Access ◽  
And Performance ◽  
Cellular Components ◽  
Comparative Information

During therapeutic plasma exchange (TPE), a large volume of a patient’s plasma is separated from the cellular components of the blood and replaced with appropriate fluids to remove circulating plasma components and disease mediators such as antibodies, cholesterol, toxins and drugs. Automated TPE systems can be categorised into two distinct groups based on the method of plasma separation: centrifugal TPE (cTPE) and membrane filtration TPE (mTPE). While technical and performance parameters for various TPE systems have been reported previously, the recent publication of several head-to-head studies directly comparing the Spectra Optia® cTPE system (Terumo BCT, Lakewood, CO, US) with mTPE systems has increased the understanding of their performance. This review summarises the comparative information between the systems. Although both device types are well tolerated, the majority of technical variables favour the cTPE system over mTPE systems, with a low risk of clotting events and benefits in plasma removal efficiency and hence procedure time. Platelet loss with the cTPE system was also shown to be similar or reduced compared with mTPE systems. Finally, flow rate requirements limit the use of peripheral venous access with mTPE devices, but not cTPE devices. Conclusively, several important differences exist between cTPE and mTPE systems that may influence treatment decisions.

Training of Undergraduate Clinicians in Vascular Access: An Integrative Review

2012 ◽  
Vol 17 (3) ◽  
pp. 146-158 ◽  
Author(s):  
Evan Alexandrou ◽  
Lucie Ramjan ◽  
Jeff Murphy ◽  
Leanne Hunt ◽  
Vasiliki Betihavas ◽  
...  
Keyword(s):  
Skill Acquisition ◽  
Vascular Access ◽  
Search Strategy ◽  
Venous Access ◽  
Training Methods ◽  
Design Studies ◽  
Medical Practitioners ◽  
Staff Members ◽  
Methodologic Quality ◽  
Peripheral Venous Access

Abstract Introduction: Peripheral venous cannulas are predominantly inserted by nurses and medical practitioners. Placement and related care of such devices are one of the most frequently performed tasks by these staff members. Clinicians in training should be given ample opportunity to practice these skills before patient encounters begin. Aims: To identify the best available evidence on the training of undergraduate clinicians in peripheral venous access. Methods: We used an integrative literature review method that considered both experimental- and nonexperimental-design studies that addressed the issue of clinician peripheral venous access training of undergraduates. The electronic databases Medline, Embase, Ovid Nursing Database, British Nursing Index, Pre Medline, Mosby's Index, and CINAHL were searched using a predetermined search strategy. The Cochrane and Joanna Briggs databases were also searched along with the reference lists of published materials. Results: A total of 56 articles were retrieved using the defined search strategy. There were 11 experimental-design studies and 1 nonexperimental-design study selected for final review after independent assessment for methodologic quality. Retrieved articles found disparity between actual skill and student self-evaluation. Teaching methods varied with the use of traditional task trainers and high-fidelity simulation. No method was found to be superior. Conclusion: Skill acquisition in vascular access is an international issue and one that has been addressed in varying degrees. We identified heterogeneity in training methods that were tailored to institutional requirements and resources. Training in this skill is imperative to ensure competency before patient encounters.

The use of peripherally inserted central catheter reduced the incidence of phlebitis in heart failure patients: A randomized trial

2021 ◽  
pp. 112972982110596
Author(s):  
Eunice Vieira Cavalcante Silva ◽  
Marcelo Eidi Ochiai ◽  
Kelly Regina Novaes Vieira ◽  
Antonio Carlos Pereira Barretto
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Severe Heart Failure ◽  
Decompensated Heart Failure ◽  
Venous Access ◽  
Control Group ◽  
Control Groups ◽  
Heart Failure Patients ◽  
Peripheral Venous Access ◽  
And Control

Background: During decompensated heart failure, the use of intravenous inotropes can be necessary. With peripheral venous access, prolonged inotrope infusion can cause phlebitis. However, traditional central venous catheters have possible complications. Peripherally inserted central catheters (PICCs) may be an alternative to traditional catheters. Aim: Our objective was to compare the incidence of phlebitis between patients with PICC and those with peripheral venous access catheter indwelling. Methods: In a randomized clinical trial, the patients were randomized to PICC and control groups, with 40 patients in each group. The inclusion criteria were hospitalized patients with advanced heart failure, ejection fraction of <0.45, and platelet count of >50,000/mm3 and current use of continuous intravenous infusion of dobutamine. The patients were randomly assigned to receive a PICC or keep their peripheral venous access. The primary end point was the occurrence of phlebitis. Results: The PICC and control groups included 40 patients each. The median age was 61.5 years; ejection fraction, 0.24; and dobutamine dose, 7.73 µg/(kg min). Phlebitis occurred in 1 patient (2.5%) in the PICC group and in 38 patients (95.0%) in the control group, with an odds ratio of 0.10% (95% confidence interval: 0.01%–1.60%, p < 0.001). Conclusion: In conclusion, in severe heart failure patients who received intravenous dobutamine, PICC use reduced the incidence of phlebitis when compared to patients with peripheral venous access. Therefore, the PICC use should considered over peripheral venous access for prolonged intravenous therapy in heart failure patients.

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