scholarly journals Extravasation of antineoplastic agents in an Oncological Center

2021 ◽  
Vol 10 (11) ◽  
pp. e361101119814
Author(s):  
David Siqueira Gonçalves ◽  
Hernandes Cerqueira de Souza Silva ◽  
Regiane Conceição
Keyword(s):  
Antineoplastic Agents ◽  
Uterine Cancer ◽  
Alkylating Agents ◽  
Performance Status ◽  
Venous Catheter ◽  
Cancer Staging ◽  
Venous Access ◽  
Cross Sectional ◽  
Peripheral Venous Access ◽  
Oncological Center

Introduction/Objective: This retrospective cross-sectional cohort study analyzed the extravasation index of antineoplastic therapy agents, demographic and clinical data. Methods: Seventy-six patients were evaluated in the period between 2017-2019. The project was approved by the Research Ethics Committee of a Brazilian Foundation. Results: In 72 months, 105,890 applications were administered, of which the incidence rate of extravasation of antineoplastic agents was 0.071%. Patients (N=311) selected for this study had a mean age of 55.42 years and a median age of 57. The most frequent diagnoses were breast cancer (11.66%), ovarian cancer (10%), colon cancer (8.33), rectal cancer (8.33) and uterine cancer (8.33%). The main variables that presented a significant impact with p <0.05 were ECOG Scale of Performance Status, ethnicity, age (risk ratio of 3% plus for each year of life), cancer staging, lymphadenectomy, use of venous catheter, forearm puncture, use of alkylating and alkaloids agents in peripheral venous access, and patients with tumor located in the pelvis using alkylating agents. Conclusion: The findings reinforce the need for further studies, since it was not possible to compare results with some variables that demonstrated a significant increase in the risk for the event.

scholarly journals Adhesion of nursing to the blood current infection protocol

2018 ◽  
Vol 12 (9) ◽  
pp. 2361
Author(s):  
Natiele Crivelaro ◽  
Ligia Marcia Contrin ◽  
Lucia Marinilza Beccaria ◽  
Isabela Shumaher Frutuoso ◽  
Ana Maria Rodrigues Da Silveira ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Venous Catheter ◽  
Venous Access ◽  
Clinical Protocols ◽  
Central Venous ◽  
Cross Sectional ◽  
Peripheral Venous Access ◽  
Nursing Team ◽  
Terapia Intensiva

ABSTRACTObjective: to verify the adherence of the nursing team to the protocol of bloodstream infection in patients using intravascular catheters. Method: A quantitative, field, cross-sectional, observational and descriptive study was carried out in a special teaching hospital in six intensive care units. Nurses' checklists were used at the bedside, in the morning, afternoon and evening shifts, from May to August, 2017. Initial (baseline) characteristics were described with counts (%), averages (SD) or medians (IQR) when appropriate. Results: it was verified, in relation to the central venous catheter / peripheral venous access dressing, that 866 (91.64%) were correctly identified and 22 (2.33%) were dirty; 803 (84.97%) were correctly fixed and 11 (1.06%) were wet. Regarding identification, the teams were correct (n = 647; 68.47%) and the colored ribbons were present in 643 (68.04%). During ICU stay, 20 (2.12%) patients had bloodstream infection related to the use of a central catheter. Conclusion: high adherence of the nursing team to the protocol and low index of bloodstream infection related to the central venous catheter when compared with the literature. Descriptors: Nursing team; Clinical Protocols; Blood flow; Patient safety; Catheter-Related Infections. Descriptors: Nursing, Team; Clinical Protocols; Blood Circulation; Catheter-Related Infections; Patient Safety.RESUMOObjetivo: verificar a adesão da equipe de Enfermagem ao protocolo de infecção de corrente sanguínea em pacientes em uso de cateteres intravasculares. Método: estudo quantitativo, de campo, transversal, observacional e descritivo, desenvolvida em um hospital de ensino de porte especial, em seis unidades de terapia intensiva. Foram utilizados checklists preenchidos por enfermeiros à beira do leito, nos turnos matutino, vespertino e noturno, de maio a agosto de 2017. Características iniciais (basais) foram descritas com contagens (%), médias (DP) ou medianas (IQR) quando adequadas. Resultados: verificou-se, em relação ao curativo do cateter venoso central/acesso venoso periférico, que 866 (91,64%) estavam identificados corretamente e 22 (2,33%) estavam sujos; 803 (84,97%) estavam fixados de forma correta e 11 (1,06%) estavam úmidos.  Em relação à identificação, os equipos estavam corretos (n=647; 68,47%) e as fitas coloridas estavam presentes em 643 (68,04%). Durante a permanência na UTI, 20 (2,12%) pacientes tiveram infecção de corrente sanguínea relacionada ao uso de cateter central. Conclusão: constatou-se alta adesão da equipe de Enfermagem ao protocolo e baixo índice de infecção de corrente sanguínea relacionada ao cateter venoso central quando comparado com a literatura. Descritores: Equipe de Enfermagem; Protocolos Clínicos; Corrente Sanguínea; Segurança do Paciente; Infecções Relacionadas a Cateter.RESUMENObjetivo: verificar la adhesión del equipo de Enfermería al protocolo de infección de flujo sanguíneo en pacientes en uso de catéteres intravasculares. Método: estudio cuantitativo, de campo, transversal, observacional y descriptivo, desarrollado en un hospital de enseñanza de porte especial, en seis unidades de terapia intensiva. Se utilizaron checklists rellenados por enfermeros al borde del lecho, en los turnos matutino, vespertino y nocturno, de mayo a agosto de 2017. Las características iniciales (basales) se describieron con recuentos (%), medias (DP) o medianas (IQR) cuando adecuadas. Resultados: se verificó, en relación al curativo del catéter venoso central / acceso venoso periférico, que 866 (91,64%) estaban identificados correctamente y 22 (2,33%) estaban sucios; 803 (84,97%) estaban fijados de forma correcta y 11 (1,06%) estaban húmedos. En cuanto a la identificación, los equipos eran correctos (n = 647; 68,47%) y las cintas coloreadas estaban presentes en 643 (68,04%). Durante la permanencia en la UTI, 20 (2,12%) pacientes tuvieron infección de corriente sanguínea relacionada al uso de catéter central. Conclusión: se constató alta adhesión del equipo de Enfermería al protocolo y bajo índice de infección de corriente sanguínea relacionada al catéter venoso central en comparación con la literatura. Descriptores: Grupo de Enfermería, Protocolos Clínicos, Circulación Sanguínea; Seguridad del Paciente, Infecciones Relacionadas a Cateter.

scholarly journals ANALYSIS OF NURSING CARE TO USERS OF PERIPHERAL VENOUS ACCESS

2018 ◽  
Vol 4 ◽  
Author(s):  
Alana Oliveira Porto ◽  
Carla Bianca De Matos Leal ◽  
Dieslley Amorim De Souza ◽  
Jéssica Lane Pereira Santos
Keyword(s):  
Nursing Care ◽  
Venous Catheter ◽  
Venous Access ◽  
Cross Sectional Study ◽  
Surgical Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Professional Identification ◽  
Peripheral Venous Catheter ◽  
Peripheral Venous Access

Objective: To analyze the nursing care provided to users of peripheral venous catheter. Method: Descriptive, cross-sectional study, performed at a mid-sized hospital situated in the high productive backcountry of Bahia, whose participants were surgical patients using peripheral venous catheters for more than 72 hours. Results: 103 patients were included; 15.5% of the bandages were dirty and/or wet, 40.8% had no date of insertion, 58.3% had no professional identification, 34.9% showed signs of infection, 50.4% did not have records on the chart and 33% presented bacterial growth. Conclusion: Nursing care to users of peripheral venous catheters has not been adequate, resulting in preventable complications when considering scientific recommendations for care with peripheral venous access.

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. 

Mini-midline in difficult intravenous access patients in emergency department: A prospective analysis

2019 ◽  
Vol 21 (4) ◽  
pp. 449-455
Author(s):  
Emanuele Gilardi ◽  
Rosangela Giannuzzi ◽  
Kidane WoldeSellasie ◽  
Alfonso Piano ◽  
Mauro Pittiruti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Room ◽  
Treatment Time ◽  
Venous Catheter ◽  
Cost Effective ◽  
Venous Access ◽  
Prolonged Treatment ◽  
Intravenous Access ◽  
Peripheral Venous Access ◽  
The Mean

Background: “Difficult intravenous access” patients represent a challenge within an emergency department as they often require many attempts to insert a peripheral short cannula in the emergency room or during the whole hospitalization. This can lead to many problems in terms of patient discomfort, increase of cost, and prolonged treatment time. Objectives: This study aimed to reduce the number of attempts needed for a short-cannula insertion or preventing insertion of a central vascular access by placing an ultrasound-guided long cannula during the emergency department visit. Material and methods: The insertion of mini-midline was monitored within an emergency room in 50 patients considered difficult intravenous access patients, who failed two attempts at peripheral venous access insertion and/or required the use of an alternative vascular device. Results: A total of 46 patients out of 50 were monitored. In 38 (82%) patients, the device was removed due to the end of the indication, and in six of them, it was replaced by a central venous catheter. Two devices were left inside even after discharge and were then removed at the end of indication. In eight (17%) patients, the device was removed due to accidental removal (4) and malfunction (4). In all the cases, the average duration of the insertion procedure was 10 min. The mean dwell time accounted to 7 and 9 days. Conclusion: The insertion of a mini-midline as part of the first emergency room visit in selected patients is a rapid, safe, and cost-effective procedure, which can provide the patient with stable venous access during the all hospitalization time.

scholarly journals Predisposing factors for peripheral intravenous puncture failure in children

2012 ◽  
Vol 20 (6) ◽  
pp. 1072-1080 ◽  
Author(s):  
Daniela Cavalcante de Negri ◽  
Ariane Ferreira Machado Avelar ◽  
Solange Andreoni ◽  
Mavilde da Luz Gonçalvez Pedreira
Keyword(s):  
Central Venous Catheter ◽  
Prevalence Ratio ◽  
Venous Catheter ◽  
Clinical History ◽  
Venous Access ◽  
Predisposing Factors ◽  
University Hospital ◽  
Central Venous ◽  
Cross Sectional ◽  
History Of

OBJECTIVE: To identify predisposing factors for peripheral intravenous puncture failure in children. METHODS: Cross-sectional cohort study conducted with 335 children in a pediatric ward of a university hospital after approval of the ethics committee. The Wald Chi-squared, Prevalence Ratio (PR) and backward procedure (p≤0.05) tests were applied. RESULTS: Success of peripheral intravenous puncture was obtained in 300 (89.5%) children and failure in 35 (10.4%). The failure rates were significantly influenced by: presence of clinical history of difficult venous access, malnourishment, previous use of peripherally inserted central venous catheter, previous use of central venous catheter, and history of phlebitis or infiltration. In the multivariate model, being malnourished and having previously been submitted to central venous catheterization were the predisposing factors for the failure. CONCLUSION: The failure rate of 10.4% is similar to that identified in analogous studies and was influenced by characteristics of the children and intravenous therapy. In association with this, malnutrition and previous use of a central venous catheter were the most important variables influencing increase in peripheral intravenous puncture failure.

Justification for deployment of peripherally inserted central catheter (PICC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18257-e18257
Author(s):  
João Raphael Maia ◽  
Flavia Torrecillas ◽  
Marcio Borella
Keyword(s):  
Breast Cancer ◽  
Central Venous Access ◽  
Venous Access ◽  
Cross Sectional Study ◽  
Peripheral Vein ◽  
Central Venous ◽  
Cross Sectional ◽  
Peripheral Venous Access ◽  
Fast Start ◽  
The Relationship

e18257 Background: Is not practical in countries of Latin America the use of Central Venous Catheters - CL in Oncology due the difficulty of financing of this procedure. The PICC is a vascular access device inserted in peripheral vein infusion drugs with Center for a cost of no more than 20% when compared to use of a catheter fully deployed. Methods: We conducted a cross-sectional study, retrospective and quantitative data were collected from complication and pharmacovigilance of a private oncology outpatient clinic in Rio de Janeiro, in the care of patients undergoing treatment for breast cancer with Paclitaxel weekly in the Jan 2016 period the Dec 2016. Results: The study were performed with 98 patients, peripheral venous access 75.5% and 24.5% central venous access. Of patients with peripheral venous access, 47.3% had exclusive member to puncture. Of this group, 21.6% of patients achieved success on first CL in all infusions performed in the period and 78.4% needed more than one CL for Administration of paclitaxel in at least an infusion. 182 Pharmacovigilance notifications were made, being 38.5% for the flebogênicidade symptoms after use of paclitaxel. Conclusions: The study highlights the relationship between venous access safe and successful outpatient antineoplasic therapy. The data observed in analyzed period justifies the creation of deployment Protocol of PICC for patients with breast cancer to treatment with Paclitaxel weekly. It is hoped with this Protocol added convenience and safety for the patient, ensuring fast start of infusional therapy often delayed by the difficulty in accessing the patient's venous network, reducing and avoiding delays in cycles, with low rates of complications for the same and lower costs.

scholarly journals Intramuscular ketamine to facilitate pediatric central vascular access

CJEM ◽  
2004 ◽  
Vol 6 (04) ◽  
pp. 259-262 ◽  
Author(s):  
T. Kent Denmark ◽  
Jenny R. Hargrove ◽  
Lance Brown
Keyword(s):  
Vascular Access ◽  
Central Venous Access ◽  
Tertiary Care ◽  
Case Series ◽  
Venous Catheter ◽  
Venous Access ◽  
Central Venous Catheters ◽  
Emergency Physicians ◽  
Central Venous ◽  
Peripheral Venous Access

ABSTRACT Objectives: Obtaining prompt vascular access in young children presenting to the emergency department (ED) is frequently both necessary and technically challenging. The objective of our study was to describe our experience using intramuscular (IM) ketamine to facilitate the placement of central venous catheters in children presenting to our ED needing vascular access in a timely fashion. Methods: We performed a retrospective medical record review of all pediatric patients &lt;18 years of age who presented to our tertiary care pediatric ED between May 1, 1998, and August 7, 2003, and underwent the placement of a central venous catheter facilitated by the use of IM ketamine. Results: Eleven children met our inclusion criteria. Most of the children were young and medically complicated. The children ranged in age from 6 months to 8 years. The only complication identified was vomiting experienced by an 8-year-old boy. Emergency physicians successfully obtained central venous access in all subjects in the case series. Conclusions: The use of IM ketamine to facilitate the placement of central venous catheters in children who do not have peripheral venous access appears to be helpful. Emergency physicians may find it useful to be familiar with this use of IM ketamine.

scholarly journals Red Blood Cell Exchange in children with Sickle Cell Disease in French Guiana

2020 ◽  
Author(s):  
Narcisse Elenga ◽  
Vincent Vantilcke ◽  
Elise Martin ◽  
Emma Cuadro ◽  
Mickael Parisot ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Blood Cell ◽  
Sickle Cell ◽  
Red Blood Cell ◽  
Venous Catheter ◽  
Venous Access ◽  
Stroke Recurrence ◽  
Cell Disease ◽  
Blood Exchange ◽  
Peripheral Venous Access

The aim of our study was to describe our experience using a Spectra Optia&reg; automated apheresis system in children with sickle cell disease (SCD). We used automated red blood cell exchange (RCE) to treat acute and chronic complications in 75 children with SCD who had a median age of 10 years [7-13]. We analysed 649 exchange sessions. Peripheral venous access was limited in a number of the children, thus requiring a femoral central double‐lumen venous catheter (CVC). We recommend the use of heparin locking, with 500 units in each lumen of a CVC. This method was well tolerated, with few complications during the procedures. For preoperative prevention, all of the patients had achieved a post-RCE HbS level of &lt;30% since this is a mandatory condition imposed by the anaesthesiologist. With a post-RCE Hb level of approximately 10-11 g/dL, a blood exchange volume of &ge;32 mL/kg, and an interval between each RCE procedure of &le;30 days, it was able to maintain the residual HbS level below 30%. Despite a target pre‐exchange HbS level of 47%, we did not encounter a single stroke recurrence. Erythrocytapheresis is useful and safe for children with SCD.

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