Journal of intravenous nursing : the official publication of the Intravenous Nurses Society
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The probability of recurrent stroke in children with sickle cell disease is high. Routine transfusion therapy has proven to be a successful preventative therapy for controlling the complications of this hematologic disorder. Other complications related to chronic transfusion also can be limited or prevented in most patients. In this article, the author discusses the sickle cell process, pathophysiology characteristics and treatment, transfusion therapy, and the complications that may result from frequent administration of multiple transfusions.
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In 1982, Southern Regional Medical Center in Riverdale, Ga, instituted a program for selected intravenous nurses to insert and manage peripherally inserted central catheters (PICCs). At present, approximately 125 to 150 PICCs are inserted annually by eight experienced IV nurses. In this retrospective study, the authors review medical record data on PICC insertions that occurred between January 1987 and December 1991. ⋯ This study focuses on the initial location of the PICC and actions taken to correct the initial tip placement if not in the SVC. Medical records were reviewed for complications including mechanical phlebitis, infections, ruptured catheters, clotted catheters, or vein thromboses. The frequency of these complications, their prevention, and management are discussed.
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Developments in vascular access technology, along with advances in therapy, have created specific challenges for the intravenous nurse caring for patients with indwelling vascular access devices. The nurse clinician must be aware of clinical and technical complications that may occur, as well as the nursing management of those complications.
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Comparative Study
Peripherally inserted central catheters. Guidewire versus nonguidewire use: a comparative study.
To date, no research articles have been published that explore the practice of using guidewires for placement of peripherally inserted central catheters. The literature contains speculations regarding the pros and cons of guidewire use. However, no studies to date have compared patient outcomes when peripherally inserted central catheter lines are inserted with and without guidewires. ⋯ No significant differences in phlebitis rates between the two study sites were found. Other catheter-related and noncatheter-related complications were similar between the two facilities. The results of this study do not support the belief that guidewire use increases complication rates.