Vein cannulation success rates by German paramedics: a single-centre study

Introduction: Gaining intravenous (IV) access is vulnerable to errors and failure, and this study analysed IV procedures by paramedics in the federal state of Hesse in Germany to examine these. Methods: This was a single-centre, observational, pilot study survey on gaining vascular access. As well as identifying the success and failure rate of IV attempts, factors associated with a higher risk of failure were analysed using logistic regression, Χ2 or Fisher's exact test. Results: A total of 207 vascular access attempts were included in the analysis, of which 90.34% were successful. Significantly associated with higher risk of failure were patients' age (OR 1.05; 95% (CI 1.02–1.10); p=0.041), or when two (OR 3.94; 95% CI (2.39–6.20); p≤0.001) or more than three attempts (OR: 3.26 [95% CI: 1.35; 5.17]; p=0.003) were needed rather than one. In contrast, risk of failure was significantly lower when patients indicate a good (OR 0.02; 95% CI (0.00–0.15); p≤0.001) or moderate (OR 0.04 (95% CI 0.01–0.17); p≤0.001) vein status compared to a bad vein status. Failure rates were higher when paramedics were working a night shift (OR 0.06; 95% CI (0.00–0.98); p=0.005) rather then during the day. Conclusion: A proportion of IV access attempts by paramedics are unsuccessful and, if paramedics are to provide invasive interventions, non-IV options for drug administration should be available.

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Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: a descriptive cross-sectional single-centre study

BMJ Open ◽

10.1136/bmjopen-2014-004794 ◽

2014 ◽

Vol 4 (4) ◽

pp. e004794 ◽

Cited By ~ 34

Author(s):

Kurubaran Ganasegeran ◽

Pukunan Renganathan ◽

Rizal Abdul Manaf ◽

Sami Abdo Radman Al-Dubai

Keyword(s):

Type 2 Diabetes ◽

Anxiety And Depression ◽

Single Centre ◽

Cross Sectional ◽

Centre Study ◽

Factors Associated ◽

Single Centre Study

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Does the presence of a trainee compromise success of biliary cannulation at ERCP?

Endoscopy International Open ◽

10.1055/s-0043-105579 ◽

2017 ◽

Vol 05 (07) ◽

pp. E559-E562 ◽

Cited By ~ 4

Author(s):

John Frost ◽

Arun Kurup ◽

Sharan Shetty ◽

Neil Fisher

Keyword(s):

Primary Outcome Measure ◽

Success Rates ◽

Serious Adverse Events ◽

Biliary Cannulation ◽

Exact Test ◽

Cannulation Technique ◽

Cannulation Success ◽

A Prospective Study ◽

Mean Time ◽

Training Protocol

Abstract Background and study aims Findings in the literature are conflicting on whether trainee involvement in endoscopic retrograde cholangiopancreatography (ERCP) procedures is detrimental to cannulation success rates. We addressed this in a prospective study, where cannulation success with or without trainee presence was the primary outcome measure. Patients and methods We prospectively recorded data on 2 senior endoscopists and their trainees over an 18-month period for ERCPs in patients with a virgin ampulla. Presence or absence of a trainee at ERCP procedures was pragmatic, reflecting their other service or training commitments or annual leave. For trainee presence, the training protocol allowed them 6 minutes of supervised time in which to achieve biliary cannulation after reaching the ampulla. Study outcome measures included cannulation success, time to cannulation, technique, whether this was achieved independently by the trainee, and complications. Results There were 219 procedures recorded and analyzed (134 with a trainee, 85 without). Three trainees were involved. Selective biliary cannulation was achieved in 201 (92 %) of cases. When a trainee was present, cannulation was successful in 122/134 procedures (91 %), compared to 79/85 (93 %) with a senior endoscopist alone (P = 0.8, Fisher’s exact test). Mean time to biliary cannulation with a trainee present was 7 minutes, compared with 5 minutes with no trainee. Mean time for successful independent cannulation by the trainee was 4 minutes, and 9 minutes for a consultant following a trainee’s attempt. There were no serious adverse events. Conclusion Our study shows that with this training protocol, involvement of a trainee on a routine secondary care ERCP list does not impair biliary cannulation success, and does not prolong a subsequent attempt by the senior endoscopist if initially unsuccessful. These findings support the involvement of trainees in routine ERCP lists with this training protocol.

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Granulomatous Mastitis and Factors Associated with Recurrence: An 11-Year Single-Centre Study of 113 Patients in Singapore

World Journal of Surgery ◽

10.1007/s00268-019-05014-x ◽

2019 ◽

Vol 43 (7) ◽

pp. 1737-1745 ◽

Cited By ~ 2

Author(s):

Qing Ting Tan ◽

Samantha Piaoxue Tay ◽

Mihir Ananta Gudi ◽

Nivedita Vikas Nadkarni ◽

Swee Ho Lim ◽

...

Keyword(s):

Granulomatous Mastitis ◽

Single Centre ◽

Centre Study ◽

Factors Associated ◽

Single Centre Study

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A prospective observational prevalence study of elevated HbA1c among elective surgical patients

Scientific Reports ◽

10.1038/s41598-020-76105-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

L. M. Teo ◽

W. Y. Lim ◽

Y. Ke ◽

I. K. L. Sia ◽

C. H. Gui ◽

...

Keyword(s):

Glycated Haemoglobin ◽

Serum Glucose ◽

Primary Objective ◽

Surgical Patients ◽

Single Centre ◽

Factors Associated ◽

Patient Demographics ◽

High Prevalence ◽

Single Centre Study

Abstract Type 2 Diabetes Mellitus (DM) is a chronic disease with high prevalence worldwide. Using glycated haemoglobin (HbA1c) as a surrogate for potential pre-DM and DM conditions, our primary objective was to determine the HbA1c epidemiology in non-cardiac elective surgical patients in Singapore. Our secondary aim was to identify risk factors associated with elevated HbA1c. We conducted a prospective, observational single-centre study in adult patients. HbA1c screening was performed. Patient demographics and comorbidities were recorded. Patients were divided into those with HbA1C ≤ 6.0% and HbA1C ≥ 6.1%. Regression analyses were performed to identify associated factors. Subgroup analysis was performed comparing patients with HbA1C ≥ 6.1% and HbA1C ≥ 8.0%. Of the 875 patients recruited, 182 (20.8%) had HbA1c ≥ 6.1%, of which 32 (3.7%) had HbA1c ≥ 8%. HbA1C ≥ 6.1% was associated with Indian ethnicity [1.07 (1.01–1.13), p = 0.023], BMI > 27.5 [1.07 (1.02–1.11), p = 0.002], higher preoperative random serum glucose [1.03 (1.02–1.04), p < 0.001], pre-existing diagnosis of DM [1.85 (1.75–1.96), p < 0.001] and prediabetes [1.44 (1.24–1.67), p < 0.001], and peripheral vascular disease [1.30 (1.10–1.54), p = 0.002]. HbA1c ≥ 8% had an additional association with age > 60 years [0.96 (0.93–0.99), p = 0.017]. The prevalence of elevated HbA1c is high among the surgical population. Targeted preoperative HbA1c screening for at-risk elective surgical patients reduces cost, allowing focused use of healthcare resources.

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