The journal of vascular access
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Comparative Study
The use of ultrasound for peripheral IV placement by vascular access team nurses at a tertiary children's hospital.
Children receiving treatment in the hospital frequently require intravenous (IV) access. Placement of short peripheral catheters can be painful and challenging especially in those children who have difficult access. Many children's hospitals have teams of specialized vascular access nurses experienced in peripheral catheter insertion, and at times use vein visualization devices, including ultrasound (US), to assist in peripheral IV placement. Our objectives were to describe the prevalence and success rate of US-guided peripheral IV placement by vascular access team nurses at a single tertiary children's hospital. ⋯ Vascular access team nurses use US infrequently for peripheral IV placement, including in children with difficult access. Methods to increase its skillful use in difficult access patients and improve successful IV placements should be explored.
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Observational Study
Low-angled peripheral intravenous catheter tip placement decreases phlebitis.
Peripheral intravenous catheters (PIVCs) are frequently removed due to phlebitis. We hypothesized that catheters made of polyurethane, which is more flexible than Teflon, would decrease phlebitis, and that flexibility could be estimated by measuring the catheter-tip angle. Ultrasonography in two groups of patients with different catheter types was then used to compare catheter-tip angles and phlebitis. ⋯ The frequency of phlebitis was lower in the polyurethane, in which the catheter was placed at lower angle, almost parallel to the vessel. Our results will aid in developing new catheters and in improving PIVC-securement techniques.
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Comparative Study
Quality-of-life assessment: arm TIVAD versus chest TIVAD.
Venous access devices are essential for the provision of care for patients requiring chemotherapy. Totally implanted venous access devices (TIVADs), also known as ports, are an option for infusion care. Medical devices have an impact upon patient quality of life. We assessed the impact on quality of life and satisfaction with their venous device, for patients with a chest TIVAD versus an upper arm TIVAD. ⋯ Quality of life for those requiring intravenous chemotherapy is very important. This should be considered when selecting an infusion device. Venous ports were positively received by the subjects in our study and there were fewer negative impacts upon subject satisfaction and quality of life for those with upper-arm devices.
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Randomized Controlled Trial
Tegaderm™ CHG dressing significantly improves catheter-related infection rate in hemodialysis patients.
Catheter-related infections are an important clinical problem in maintenance hemodialysis patients. Catheter-related bloodstream infections have a negative effect on survival, hospitalization and cost of care. Tegaderm™ chlorhexidine gluconate (CHG) dressing may be useful to reduce catheter-related infection rates. ⋯ This is the first prospective study to show that Tegaderm™ CHG dressing significantly reduces catheter-related infection rates in hemodialysis patients.
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Observational Study
Ultrasound-guided supraclavicular central venous catheter tip positioning via the right subclavian vein using a microconvex probe.
The ultrasound-guided central venous catheter (CVC) guidewire tip positioning has been demonstrated for catheterization of the right internal jugular vein. We explored the feasibility of an ultrasound-guided right subclavian vein (RScV) CVC tip positioning via a right supraclavicular approach using a microconvex probe. ⋯ Ultrasound-guided CVC tip confirmation following catheterization of the right subclavian vein via a right supraclavicular approach with a microconvex probe is feasible.