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How to manage fluid and electrolyte imbalances

iv drip

Maintaining the balance of fluid and electrolytes is crucial to the care of patients across the continuum” Walker (2016). Abstract: Maintaining the balance of fluid and electrolytes is crucial to the care of patients across the continuum. To do this, a practitioner must be cognizant of key monitoring and assessment parameters. Key electrolytes, their function […]

What are the risks and benefits of intravenous lipid emulsion therapy

implantable port site

This article will explain the available formulations of IVFE, administration, and maintenance issues, as well as the risks and benefits for various applications” Spray (2016). Abstract: Intravenous fat emulsion (IVFE) is an important source of calories and essential fatty acids for patients receiving parenteral nutrition (PN). Administered as an individual infusion or combined with PN, […]

Practical considerations for self-administration of subcutaneous immunoglobulin G

central line days

Successful IGHy self-administration depends on proper patient training and continuing interaction between the health care team and the patient to optimize the patient experience” Miars et al (2016). Abstract: An approved subcutaneous infusion of immunoglobulin G using recombinant human hyaluronidase (IGHy) allows adult patients with primary immunodeficiency disease to self-administer every 3 to 4 weeks […]

Lyme disease treatment and the impact on infusion nurses

infusion

The Centers for Disease Control and Prevention estimates that more than 300 000 new cases of Lyme disease occur each year in the United States and that 10% to 20% of these patients will remain symptomatic despite receiving appropriate antibiotic therapy” Maloney (2016). Abstract: The Centers for Disease Control and Prevention estimates that more than […]

Identifying OPAT patients from a blood culture database

CVC

The clinical and cost-effectiveness of outpatient parenteral antimicrobial therapy (OPAT) services are well described. We used a blood culture database as a novel approach to case finding and determined its utility in identifying inpatients suitable for OPAT” Melzer et al (2016). Abstract: BACKGROUND: The clinical and cost-effectiveness of outpatient parenteral antimicrobial therapy (OPAT) services are […]

Central venous catheters for the management of pericardial effusions

shock

The aim of this study was to determine the performance, pain, and quality of life on use of central venous catheter (CVC) for drainage of pericardial effusion in patients undergoing open heart surgery” Ghods et al (2016). Abstract: Different pericardial catheters have been suggested as an effective alternative method for drainage of pericardial effusion. The […]

What is the current practice of hypoglycemia management in the ED?

AccuVein reviewed

About one-third of patients had refractory or recurrent hypoglycemia and infection was associated with this occurrence. Lack of dextrose containing intravenous fluid was associated with the incidence of recurrent hypoglycemia” Bilhimer et al (2016). Abstract: Purpose: To characterize hypoglycemia management and identify characteristics associated with refractory (need for additional treatment following initial management) and recurrent […]

What are the rates of CLABSI in pediatric intensive care units of Pakistan

chlorhexidine skin antisepsis

We assessed the effect of implementation of active infection control and surveillance on the occurrence of device-associated infections (DAIs) in our PICU from 2012-2015” Haque et al (2016). Abstract: We assessed the effect of implementation of active infection control and surveillance on the occurrence of device-associated infections (DAIs) in our PICU from 2012-2015. There were […]

Transfusion practices in the hematologic intensive care unit

Hepatitis E virus in blood components

Patients requiring blood transfusions in hematologic intensive care unit were included in a prospective study using a single RBC unit per transfusion and were compared with an historical cohort who received 2 RBC units per transfusion” Chantepie et al (2016). Abstract: BACKGROUND: There is increasing evidence that excessive blood transfusion may be associated with impaired […]

Drone transportation is a viable option for the delivery of blood products

platelets

To the best of our knowledge there are no studies examining the impact of drone transport on blood products, describing approaches to maintaining temperature control, or component physical characteristics during drone transport” Amukele et al (2016). Abstract: BACKGROUND: Small civilian unmanned aerial vehicles (drones) are a novel way to transport small goods. To the best […]

How to improve peripheral intravenous cannula monitoring and documentation

patient safety

The objective of this study is to improve compliance with documentation and monitoring PIVC guidelines in the medical ward of a secondary care center” Yagnik et al (2016). Abstract: Background: Peripheral intravenous cannula (PIVC) insertion is a universal intervention for inpatients and is associated with multiple complications. Effective, simple, reproducible interventions specific to PIVC complication […]

Skin antisepsis with chlorhexidine versus iodine

pain relief

There is moderate-quality evidence supporting the use of chlorhexidine for preoperative skin antisepsis and high-quality evidence that the use of chlorhexidine is associated with fewer positive skin cultures” Privitera et al (2016). Abstract: Background: Surgical site infection (SSI) is one of the most frequent health care–associated infections. One of the practices to reduce their incidence […]

Needlestick and the impact of a culture of silence

needlestick injury

About 35.7 million healthcare workers face sustaining a needlestick injury worldwide and an estimated 384,000 percutaneous injuries occur annually in United States hospitals alone” Katsevman et al (2016). Abstract: About 35.7 million healthcare workers face sustaining a needlestick injury worldwide and an estimated 384,000 percutaneous injuries occur annually in United States hospitals alone.1,2 Although needlestick […]

Risk of thromboembolism with use of PICC for transfusion?

transfusion

We assessed whether red blood cell transfusion through peripherally inserted central catheters (PICCs) affects the risk of venous thromboembolism compared with transfusion through non-PICC devices” Rogers et al (2016). Abstract: BACKGROUND: Mechanisms of red blood cell delivery and their contribution to the incidence of venous thromboembolism are not well understood in the clinical setting. We […]

How to improve compliance with the completion of CLABSI bundles

crbsi

The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs)” Lee et al (2016). Abstract: BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are […]

Update on the prevention of CRBSI

hand hygiene

Despite recent successes with prevention of CRBSI, pertinent questions regarding pathogenesis and prevention remain unanswered and work on improved surveillance, devices less prone to infection, and more effective prevention techniques are needed” Rupp and Majorant (2016). Abstract: Catheter-related bloodstream infections (CRBSI) are responsible for significant morbidity, mortality, and excess health care costs. It is increasingly […]

Infectious disease-supervised Outpatient Parenteral Antibiotic Therapy

opat

Outpatient parenteral antibiotic therapy (OPAT) is a safe and effective modality for treating serious infections. This study was undertaken to define the value of OPAT in a multicentered infectious disease (ID) private practice setting” Petrak et al (2016). Abstract: Background:  Outpatient parenteral antibiotic therapy (OPAT) is a safe and effective modality for treating serious infections. […]

Risk of haemolysis from peripheral intravenous catheters

Blood Culture

This study provides further evidence that blood drawn from cannulas is associated with increased rates of haemolysis and will test the hypothesis that patient illness severity is a confounding factor” Churcher et al (2016). Extract: In vivo haemolysis is a source of interference across a range of different assays and occurs more frequently in the Emergency […]

Pediatric outpatients presenting with fever and central venous catheter

intravenous cannulation

Although management algorithms for fever and central venous catheters (CVCs) have been implemented for pediatric oncology (PO) patients, management of pediatric outpatients with noncancer diagnoses and CVCs lacks clear protocols” Alexander et al (2016). Abstract: OBJECTIVE: Although management algorithms for fever and central venous catheters (CVCs) have been implemented for pediatric oncology (PO) patients, management […]

Safety opportunity associated with ultrasound-guided central venous cannulation

ultrasound training

In the United States alone, more than 5 million central venous catheters (CVCs) are attempted annually, of which, conservatively, 10% are associated with complications [1,2]. Without including data from any other nation, this means our specialty performs thousands of daily CVCs and oversees hundreds of quotidian complications” Brindley et al (2016). Extract: “In the United […]

Early goal-directed therapy for treating septic shock

CLABSI reduced

Studies and meta-analyses conflict regarding the use of early goal-directed therapy (EGDT) for septic shock” Simpson et al (2016). Abstract: Studies and meta-analyses conflict regarding the use of early goal-directed therapy (EGDT) for septic shock. We sought to clarify the conflict by performing a living systematic review and meta-regression. [ctt link=”wafcd” template=”1″]ReTweet if useful… Early […]

Intraosseous aspirate for the analysis of coagulation studies

picc bloods

We studied the analysis of coagulation parameters in intraosseous aspirate during stable conditions and after major haemorrhage in a porcine model” Strandberg et al (2016). Abstract: BACKGROUND: Laboratory analysis of coagulation is often important in emergencies. If vascular access is challenging, intraosseous catheterization may be necessary for treatment. We studied the analysis of coagulation parameters […]

How to treat air embolism in clinical practice

infusion pump

This article reviews the causes of air embolism, clinical management and prevention techniques” McCarthy et al (2016). Abstract: Air embolism is a rarely encountered but much dreaded complication of surgical procedures that can cause serious harm, including death. Cases that involve the use of endovascular techniques have a higher risk of air embolism; therefore, a […]

Full text review of subcutaneous infusion of fluids – hypodermoclysis

difficult intravenous access

In this review, we provide an overview of the technique, summarize findings from studies that have examined the use of subcutaneous infusion of fluids for hydration or nutrition, and describe the indications, advantages, and disadvantages of subcutaneous infusion” Caccialanza et al (2016). Abstract: Subcutaneous infusion, or hypodermoclysis, is a technique whereby fluids are infused into […]

Early training in intraosseous access recommended

central line insertion training

Training in the insertion of the IO access is not a mandatory part of the Danish medical school curriculum or early residency training in Denmark…” Afzali et al (2016). Extract: “A recent Danish study shows that the IO device is available in 74% of the Danish Emergency Departments (EDs). However, only 11% consistently established IO […]

Review of Hepatitis C virus transmission in a skilled nursing facility

peripheral iv

This outbreak highlights the importance of prompt reporting and investigation of incident HCV infection and the need for adherence to basic infection control procedures by health care personnel” Calles et al (2016). Abstract: Background: From March-May 2013, 3 cases of acute hepatitis C virus (HCV) infection were diagnosed among elderly patients residing at the same […]

Why has blood product use increased in France?

transfusion

Blood products use has increased in France between 2000 and 2011. To understand the reasons for this increase, data about transfused patients and transfusion practices needed to be updated” Fillet et al (2016). Abstract: BACKGROUND: Blood products use has increased in France between 2000 and 2011. To understand the reasons for this increase, data about […]

What is the risk of HIV infection in blood donors in the Southeastern United States

clabsi

Here we calculate HIV prevalence, incidence, and residual risk in Southeastern US blood donors and report risk factors disclosed by incident donors in counseling sessions” Crowder et al (2016). Abstract: BACKGROUND: Human immunodeficiency virus (HIV)-positive blood donors pose a risk to blood safety. The Southeastern United States has the highest reported HIV infection rates. Here […]

Red blood cell transfusion-transmitted acute hepatitis E

transfusion

Cases of transfusion-transmitted hepatitis E have rarely been documented in immunosuppressed patients, mainly after receiving frozen plasma” Riveiro-Barciela et al (2016). Abstract: BACKGROUND: Acute hepatitis E in industrialized countries is usually related to intake or manipulation of undercooked or raw meat. Cases of transfusion-transmitted hepatitis E have rarely been documented in immunosuppressed patients, mainly after […]

Neonatal intensive care unit surveillance and late-onset bacterial infection

clabsi risk factors

Surveillance cultures might be useful for the presumption of causative pathogens of late-onset bacterial infection in patients with risk factors for the development of nosocomial bacterial infection” Ichikawa et al (2016). Abstract: Background: Surveillance cultures have been recommended for infection control of resistant bacteria in neonatal intensive care units (NICUs). However, the utility of surveillance […]