Journal of infusion nursing : the official publication of the Infusion Nurses Society
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Randomized Controlled Trial Comparative Study
Administration of local anesthetic agents to decrease pain associated with peripheral vascular access.
The purpose of this study was to compare a variety of local anesthetic agents before starting an intravenous (i.v.) device to determine which method is the most comfortable for patients. Using a randomized, double-blind, placebo-controlled, pretest-posttest experimental design, the study compared 5 treatment groups (anesthetic spray, placebo spray, anesthetic intradermal injection, placebo intradermal injection, and a control group with no local anesthetic agent) in 84 emergency department patients. ⋯ Pain ratings 3 minutes after i.v. insertion were found to be similar for the 5 treatment groups. These study results do not support the use of intradermal anesthetic agents before i.v. catheter insertion.
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To prevent complications from peripheral vascular access device (PVAD) therapy, the Infusion Nurses Society (INS) developed 2 scales to measure the extent and severity of phlebitis and infiltration in PVADs. This study evaluated the psychometric properties of these scales to validate them with respect to their interrater reliability, concurrent validity, feasibility, and acceptability. A total of 182 patients at 2 sites were enrolled, and 416 observations of PVAD sites were made. ⋯ The study nurses reported the scales to be easy to use, taking an average of 1.3 minutes to complete both. The importance of valid measures for use in research cannot be underestimated. The INS Phlebitis and Infiltration scales have been shown to be easy to use, valid, and reliable scales.
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Intestinal failure (IF), typically due to short bowel syndrome in adults and congenital disorders in pediatric patients, is universally managed with parenteral nutrition (PN). When patients fail PN due to recurrent infection, loss of central venous access or PN-induced liver disease, intestinal transplant (ITx) is indicated. ⋯ ITx allows for freedom from PN but is complicated by rejection and infection. Early referral of patients with IF to centers with experience in intestinal rehabilitation and transplantation is essential to improve patient outcome.