Journal of infusion nursing : the official publication of the Infusion Nurses Society
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Anaphylaxis is a severe systemic allergic reaction that can involve multiple systems of the body. Anaphylaxis often is unpredictable, can have a rapid onset, and, if serious enough, can have life-threatening consequences. If an anaphylactic reaction is the result of an antigen antibody response, it is considered anaphylaxis. ⋯ For this reason, the infusion nurse specialist needs to have the knowledge and skills necessary to recognize and respond appropriately when anaphylaxis occurs. This article discusses the history, definition, incidence, risk factors, etiology, pathophysiology, and clinical findings of anaphylaxis. Appropriate prevention, management, and treatment also are discussed, with special attention given to medication-related anaphylaxis.
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Medication errors can be harmful, especially if they involve the intravenous (IV) route of administration. A mixed-methodology study using a 5-year review of 73,769 IV-related medication errors from a national medication error reporting program indicates that between 3% and 5% of these errors were harmful. ⋯ Nurses often participate in IV therapy, and these findings have implications for practice and patient safety. Voluntary medication error-reporting programs afford an opportunity to improve patient care and to further understanding about the nature of IV-related medication errors.
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The number of children with a diagnosis of asthma has increased significantly over the years, and asthma currently is the most common pediatric chronic disease. Asthma continues to take the lives of children at an alarming rate. Proper diagnosis, education, and appropriate management are essential for decreasing morbidity and mortality. ⋯ Immediate assessment and initiation of appropriate medications and management are essential for a positive outcome. The use of bronchodilator therapy with corticosteroids is the gold standard for acute asthma exacerbation, but it may not be effective for certain moderate to severe exacerbations. This article discusses the prevalence, pathophysiology, and diagnosis and treatment of asthma, including the role of magnesium sulfate for acute asthma exacerbations.
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Randomized Controlled Trial Clinical Trial
The effect of furosemide infusion on serum epidermal growth factor concentration after acute lung injury.
Acute lung injury and its more severe form, acute respiratory distress syndrome, are clinical syndromes of progressive hypoxemia and ventilation-perfusion mismatch with decreasing pulmonary compliance in the absence of congestive heart failure. Epidermal growth factor is involved in the pathogenesis of airway inflammation as well as a proinflammatory effect in other tissues. Furosemide has been shown to improve pulmonary gas exchange and intrapulmonary shunt by a nondiuretic mechanism in animal models of acute respiratory distress syndrome. ⋯ Serum epidermal growth factor levels also were not significantly different between the furosemide treatment group and the control group (P > .05). Continuous furosemide infusion improves oxygenation and hemodynamics in patients with acute lung injury, but not through a change in the serum epidermal growth factor level. Further study is needed to determine the exact mechanism of furosemide action in patients with acute lung injury and acute respiratory distress syndrome.
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This article reviews the results and conclusions from four pivotal and two comparative clinical trials. The six randomized, controlled, single-blinded, parallel-group clinical trials were conducted to determine which antiseptic is best for use as a patient preoperative skin preparation. The objective of these studies was to compare the immediate, persistent (residual), and cumulative antimicrobial efficacy and safety of 2% chlorhexidine gluconate (CHG) combined with 70% isopropyl alcohol (IPA) (ChloraPrep); another combination CHG and IPA antiseptic (CHG+IPA) and 2% aqueous CHG alone; 4% CHG (Hibiclens) alone; 70% isopropyl alcohol (IPA) alone; and an iodine-containing solution, 10% povidone-iodine (Betadine) alone as preoperative skin topical antiseptics for potential prevention of nosocomial infections.