Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
-
Randomized Controlled Trial Comparative Study Clinical Trial
Blood samples drawn from IV catheters have less hemolysis when 5-mL (vs 10-mL) collection tubes are used.
It is common practice for emergency nurses to draw blood for laboratory analyses into vacuum tubes from newly inserted intravenous (IV) catheters, even though this technique has been associated with an increase in sample hemolysis. No clinical nursing studies have documented the effect of collection tube size on hemolysis of samples obtained via IV catheters. ⋯ The risk of hemolyzing blood drawn from IV catheters can be significantly reduced by using 5-mL rather than 10-mL collection tubes.
-
Randomized Controlled Trial Clinical Trial
Reducing pain in ED patients during lumbar puncture: the efficacy and feasibility of iontophoresis, collaborative approach.
This study examined the efficacy and feasibility of a collaborative iontophoresis procedure for dermal anesthesia prior to lumbar puncture (LP) in adult ED patients. ⋯ Dermal anesthesia by lidocaine iontophoresis in patients undergoing an LP with emergency nurses and physicians working in collaboration during the procedure takes longer, but decreases the pain of administering anesthesia, increases provider satisfaction, and fosters collaborative practice in the emergency setting. Iontophoretic administration of anesthesia for LP is now an option for dermal anesthesia in our emergency department.
-
Randomized Controlled Trial Comparative Study Clinical Trial
What is the best topical anesthetic for nasogastric insertion? A comparison of lidocaine gel, lidocaine spray, and atomized cocaine.
Nasogastric intubation has been shown to be a painful procedure for patients. Previous studies have demonstrated the benefit of topical nasal anesthesia in decreasing the pain of this procedure. This study attempts to identify which of 3 topical anesthetic modalities would be preferred by patients. ⋯ Two percent lidocaine gel appeared to provide the best option for a topical anesthetic during nasogastric tube insertion.
-
Randomized Controlled Trial Clinical Trial
Efficacy of normal saline solution versus heparin solution for maintaining patency of peripheral intravenous catheters in children.
Literature reports support the use of normal saline solution for maintaining patency of peripheral intermittent intravenous infusion devices (PIID) in the adult population; however, there are limited data regarding this policy in the pediatric population. The purpose of this study was to establish the effects of heparin flush and saline solution flush solutions in maintaining patency of infusion devices in the pediatric population, and to establish cost-saving implications related to both procedures. The specific aims of the study included the following: (1) to determine the efficacy of normal saline solution flush for peripheral i.v. access devices for the pediatric population, and (2) to establish cost-saving implications related to normal saline solution versus heparin flush for PIIDs in terms of pharmacy costs and costs related to nursing time. ⋯ This study provided support for the efficacy of normal saline solution as an alternative to heparin solutions for the maintenance of peripheral i.v. devices. Implications include elimination of risks associated with heparin (drug incompatibilities, thrombosis syndrome, hypersensitivity reactions, local tissue damage, and iatrogenic hemorrhage); decreased potential for infection associated with breaks in the integrity of the i.v. system; substantial money savings as a result of the change to normal saline solution realized by the patient and the institution; and decreased nursing time. By simplifying the procedure, nurses have more time to provide aspects of nursing care to patients.
-
Randomized Controlled Trial Comparative Study Clinical Trial
The effect of administered crystalloid fluid temperature on aural temperature of moderately and severely injured children.
Warm intravenous fluid (W-IVF) administration is the standard of care to prevent hypothermia in injured adults. It is argued that such administration may not be helpful for treating injured children, because children often do not require as much intravenous fluid (i.v.f.) as adults. The purpose of this study was to compare the effects of W-i.v.f. to room temperature intravenous fluid (RT-i.v.f.) administration on aural temperature (Ta) in injured children during the first hour of trauma resuscitation. ⋯ When comparing the changes between baseline and final Ta for the W-i.v.f. and RT-i.v.f. groups, the standardized difference in temperature change was 0.62. Although results of the repeated measures analysis of covariance were not statistically significant, the standardized difference in temperature changes was large enough to warrant administration of W-i.v.f., even at slow flow rates, to prevent hypothermia in injured children.