American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Removal of internal jugular and subclavian central venous catheters is a common nursing intervention. Venous air embolism is a serious complication of catheter removal. Although some procedures have been recommended to prevent venous air embolism, whether nurses use these procedures and what complications patients experience are unknown. ⋯ None of the nurses sampled had venous air embolism diagnosed in their patients. They reported observing dyspnea, pain, bleeding from the insertion site, and arrhythmias. Many of the nurses reported that they did not always use all the recommended procedures; only 9 nurses (31%) reported always using all the recommended procedures.
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Recommendations on use of neuromuscular blocking agents include using peripheral nerve stimulators to monitor depth of blockade and concomitantly administering sedatives and/or analgesics. ⋯ Small and large facilities differ in concomitant use of analgesics/sedatives and peripheral nerve stimulators. Education and research are needed to ensure that patients receive adequate monitoring and sedation during administration of neuromuscular blocking agents.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Patency of radial arterial catheters.
Data on the influence of flush methods, blood-sampling methods, and site location on the patency of radial arterial catheters used for pressure monitoring are sparse. ⋯ Insertion sites closest to the bend of the wrist increase chances of maintaining patency. Catheters can be maintained with as-needed flushes, and either waste or nonwaste blood sampling can be used.