Advanced emergency nursing journal
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Apneic oxygenation during intubation is the application of oxygen via a nasal cannula, which is left in place throughout laryngoscopy. The flow rate of oxygen is set to at least 15 L/min and theoretically reduces the risk of oxygen desaturation and hypoxemia during the procedure. ⋯ Despite conflicting results, use of apneic oxygenation is becoming more prevalent and is being implemented into standard operating procedures in some clinical settings. Because of the low risk of adding a nasal cannula during intubation and the potential benefit of reducing the incidence of hypoxemia and severe oxygen desaturation, it would be prudent to implement apneic oxygenation when available.
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Randomized Controlled Trial
A Randomized, Double-Blind Trial to Determine if Vapocoolant in the Adult Population Improves Patient Perception of Pain With Peripheral Intravascular Access.
The purpose of this study was to investigate whether the use of a topical anesthetic spray (vapocoolant) at the site of intravenous access reduces pain and anxiety associated with peripheral intravenous (PIV) catheter insertion in an adult emergency department population. A randomized, double-blind, placebo-controlled, single-center trial, conducted from July to August, in an adult emergency department where 72 patients with orders for PIV insertion receiving either topical vapocoolant spray (n = 38) or placebo spray (n = 34). Vapocoolant or placebo was applied to the intravenous site and allowed to evaporate before cleansing and insertion. ⋯ Eighty-nine percent of nurses and patients would use vapocoolant in future procedures, whereas 74% would use placebo; the difference was not significant (p > 0.05). No skin blanching or lesions were noted. Among adult patients in the Parkland Emergency Department receiving PIV access, no significant differences in pain relief or alleviation of anxiety were found between treatment using a topical anesthetic spray or placebo.