The journal of vascular access
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Survey of intravascular catheter management is an essential step in the control and prevention of catheter-related infection. In recent years, most surveillance studies only included catheters from intensive care units (ICUs). Data regarding the level of care and adherence to international guidelines in a whole general institution are scarce. Our objective was to evaluate the care situation of intravascular catheters in our adult units of a General Hospital. ⋯ A rapid survey of the care situation of intravascular catheters is feasible and easy to do with our methodology. The data show great opportunity for improvement, mainly in the non-ICU areas.
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Randomized Controlled Trial Comparative Study
A prospective, randomized comparison of three different types of valved and non-valved peripherally inserted central catheters.
Few randomized studies have investigated the impact of valved and non-valved power-injectable peripherally inserted central catheters (PICCs) in terms of incidence of occlusion, infection, malfunction and venous thrombosis. ⋯ We found no clinical advantages of valved vs. non-valved PICCs.
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Observational Study
Association between multiple IV attempts and perceived pain levels in the emergency department.
Intravenous (IV) access is the most commonly performed procedure in the emergency department (ED). Patients with difficult venous access require multiple needlesticks (MNS) for successful IV cannulation and may experience increased pain with many attempts. ⋯ Patients experience increased pain in association with multiple IV attempts.
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In an emergency, the administration of fluids and medications remains a vital component of patient care. Although this is usually achieved via an intravenous line, intraosseous (IO) cannulation is accepted as a useful alternative for the administration of fluids and medications in situations where intravenous cannulation is difficult or impossible. Despite this, IO cannulation appeared to be infrequently performed by paramedics in Johannesburg (JHB). This study investigated factors that may be affecting the frequency with which IO cannulation is performed by paramedics in JHB. ⋯ Procedures are more inclined to move from the in-hospital to the prehospital environment if they are seen to be commonly performed, safe and effective. It would appear that paramedics infrequently witness IO cannulation being performed in emergency departments. This together with a lack of appropriate equipment, training and retraining including the perceived invasiveness and pain associated with the procedure appears to be dissuading paramedics from regularly performing IO cannulation.