Search

Intravenous catheter placement is a routine procedure in exotic pet medicine, yet the selection of the optimal venous site for catheterization in rabbits (Oryctolagus cuniculus) remains controversial. Recommendations differ between countries and authors, and lack evidence-based data. This prospective study aimed to document and compare the prevalence and types of complications secondary to peripheral venous catheterization in domestic rabbits as related to the vein catheterized. Catheterization events (n = 151) were randomly attributed to three groups, named according to the venous site selected: cephalic (n = 39), lateral saphenous (n = 58) and marginal ear vein (n = 54). Rabbits that needed a catheter for fluid therapy, surgery, or imaging, were included in the study. Catheters were placed by three veterinarians following a standardized method. Data regarding the patient, the type of catheter, and the treatment were recorded. Complications were evaluated every day after the catheter placement, at removal and after 15 days. Minor complications that were observed included catheters which were bent at the elbow or removed by the rabbit, and twisted or chewed tubing. Ear necrosis and signs of phlebitis were considered major complications. Catheter placement failure was significantly higher in the "cephalic" group (odds ratio = 4, 95% Confidence Interval = [16.67,1.04], P = 0.048), without differences between the operators. For the marginal ear vein, there was also a significant association between the failure rate and the length of the rabbit's ear (Wilcoxon effect size = 0.42, 95% CI = [0.14,0.64], P = 0.003). No major complication was observed in any groups. Minor complications occurred without significant differences between the groups. The results suggest that intravenous catheters in rabbits do not carry significant complications irrespective of the chosen site, but cephalic vein placement carries the highest risk of failure. [ABSTRACT FROM AUTHOR]

• Linear association between costs of infection control items and anesthesia units? • Prospective observational of 38 anesthetics, recording infection control supplies used. • Associated anesthesia units (base + time) with supply costs, linear association. • Examples show how to use to forecast annual anesthesia infection control supply costs. Some costs for anesthesia supplies to reduce intraoperative infections depend on the procedure and duration of the case. For regular anesthesia supplies and medications, costs are linearly related to American Society of Anesthesiologists' Relative Value Guide units, known for nearly all cases in the United States of America. We hypothesized linear association between costs of infection control items and anesthesia units. A prospective observational study of 38 surgical cases was performed. Usage of anesthesia infection control supplies was recorded: alcohol hand dispensers, microfiber cloths for machine disinfection, and disinfecting and cleaning caps for syringe tips, Luer connectors, and stopcocks. Cost per case was calculated using 2022 US dollar payments for those items. Using least squares linear regression to associate the anesthesia units (base + time) with supply costs, in addition to intercept and linear slope, none of 5 potential extra non-linear terms were significant (all P ≥.46). Further assessment showed lack of fit to a quadratic model. Pearson linear correlation coefficient between cost and units was 0.88. An example was created showing how to forecast annual infection control supply costs for anesthesia based on the linear model. For purposes of predicting intraoperative anesthesia supplies to reduce bacterial transmission in the anesthesia workspace, a valid approach is to assume a linear association with the total anesthesia units, a predictor generally known for all anesthetics. [ABSTRACT FROM AUTHOR]

Background: Peripheral intravenous catheters connected to an infusion pump are necessary for the delivery of fluids, nutrition, and medications to hospitalized neonates but are not without complications. These adverse events contribute to hospital-acquired patient harm. An artificial intelligence theory called fuzzy logic may allow the use of appropriate variables to predict infusion failure.Purpose: This innovative study aimed to develop an intravenous infusion nanotechnology monitoring system that would alert the nurse to impending peripheral intravenous infusion failure.Methods: An intravenous infusion nanotechnology monitoring system, using predictor variables of pressure, pH, and oxygen saturation used in a fuzzy logic alarm algorithm was developed to alert the nurse to impending peripheral intravenous infusion failure.Findings: The developed intravenous infusion nanotechnology monitoring system is composed of a peripheral intravenous catheter with nanotechnology multimodal sensor, an intravenous pump, a fuzzy logic algorithm, and alarm. For example, using this system, an elevated in-line pressure, a low pH, and a low venous oxygen level would generate an alarm for possible impending infusion failure.Implications For Practice: With further development, this technology may help nurses predict and prevent adverse outcomes from intravenous infusions. This work shows how nurses can be content experts and innovators of technology that they use to make clinical decisions.Implications For Research: After regulatory approval, a randomized controlled trial may be performed to investigate whether interventions at the time of an alarm would result in fewer adverse outcomes and improve safety. [ABSTRACT FROM AUTHOR]

Phlebitis is one of the most common complications of peripheral intravenous catheter (PIVC) that can lead to many complications, including higher medical costs and longer hospital stays. To identify the incidence of phlebitis associated with PIVC and determine its risk factors among hospitalized pediatric patients. An observational and cross-sectional design was used. Data such as patient's demographics, medical diagnosis, place of admission, and other PIVC characteristics were recorded. In addition, observations of PIVC sites over 12-hour intervals were conducted to measure PIVC complications using the Visual Infusion Phlebitis (VIP) scale. Sample and Setting. Over a period of six months, a sample consisting of 307 children from five governmental hospitals that are located in north and middle Jordan were targeted. The sample consists of patients under 12 years old with PIVCs who were hospitalized in pediatric departments. PIVC catheterization has been associated with several complications such as phlebitis (N = 164; 53.4%), extravasation (N = 107, 34.9%), pain (N = 37; 12.1%), leakage (N = 37; 12.1%), and obstruction (N = 26; 8.5%). The main risk factors for phlebitis were: children admitted to wards, PIVC inserted by novice nurse, catheter inserted in the lower limbs, and catheter with contaminated dressing. This study enriches knowledge of PIVC complications and risk factors of phlebitis to help nurses avoid complications and initiate prompt treatment, leading to decrease financial burden as well as patient pain and discomfort. [ABSTRACT FROM AUTHOR]

Aim This review aims to present a case series on pressure injury (PI) formation secondary to limb-splinting for preservation of peripheral intravascular catheter (PIVC) access in neonatal and pediatric patients. A literature review was undertaken to analyze the existing knowledge base on this phenomenon. Background Medical devices and attachments are considered a risk factor for PI development in neonates, infants, and children. Three cases of PI formation caused by contact with limb boards used to preserve PIVC access were identified in an Australian tertiary pediatric facility during 2016. Methods A literature search was conducted during December 2017 using the Cumulative Index of Nursing and Allied Health, Excerpta Medica database, MEDLINE, PubMed, and the Cochrane Library. Keywords used were pressure injury(ies) , pressure ulcer , pressure ulcers , decubitus ulcer , and decubitus ulcers . Articles were excluded if published before 2006, patients were adolescents or adults, and if injuries were not caused by PIVC-associated limb-splinting. Patients included in the case series were identified through screening of admissions in one ward of a tertiary paediatric hospital. Results Five low-quality studies were included in the literature review. Three children were included in the case series. Each child acquired a PI subsequent to limb-splinting and taping adjacent to a PIVC. Hydration, nutritional state, and oxygenation did not appear to contribute to PI development in these cases. Conclusions There is a gap in the evidence base pertaining to PIVC splinting and its involvement with PI formation in neonates, infants, and children. The existing literature provides low-quality evidence this problem exists; thus, further research is recommended. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the effect of mannitol injection into the rabbit ear vein by intravenous catheter on endothelial cells apoptosis, thrombus formation, the expression of plasma tissue factor (TF) and von Willebrand factor (vWF). MATERIALS AND METHODS: Sixty-four Zealand rabbits were randomly divided into experiment and control group and received 20% mannitol or normal saline via ear margin veins, respectively. Both groups were injected daily. On days 1, 3, 5, and 7 after catheterization, rabbits were subjected to intraperitoneal anesthesia and their ear veins were isolated and then subjected to hematoxylin and eosin staining. Cell apoptosis was evaluated using TUNEL (terminal deoxynucleotide transferase mediated d-UTP nick end labeling) staining, and the levels of TF and vWF were analyzed by enzyme-linked immunosorbent assay. RESULTS: Compared with the control group, the experiment group showed significantly increased thrombus formation (p < 0.05), and a significant higher rate of apoptosis in endothelial cells (p < 0.05) on days 3, 5, and 7. In addition, the experiment group showed significant elevation of plasma TF and vWF on days 3, 5, and 7 (p < 0.05). CONCLUSIONS: Continuous mannitol injection by intravenous catheterization induces more serious venous thrombus formation and endothelial cells apoptosis and higher TF and vWF levels than normal saline injection. These data suggest that clinical use of hyperosmotic mannitol by intravenous catheter may exert direct deleterious effects on vascular endothelium. [ABSTRACT FROM AUTHOR]

Abstract: Fluid therapy is a foundation of emergency medicine, thus its importance cannot be underestimated. Avian fluid therapy shares the general principles used for mammalian species, yet it seems appropriate to emphasize certain differences and highlight a few catheter techniques that are required to perform avian emergency medicine. As with other companion animal species, 4 main routes of fluid administration exist. However, in the critically ill avian patient, the intravenous and, more importantly, intraosseous routes of fluid administration become the clinician''s preferred methods of vascular access. This brief communication will familiarize the reader with the intravenous catheterization of the ulnar/basilic and right jugular veins and the intraosseous catheterization of the distal ulna in raptors. The step-by-step pictorial presentation of each technique will facilitate the learning experience and provide visual cues. Accompanying information will give the reader an understanding of possible complications, the authors'' suggested techniques based on the clinical presentation and the patient size, as well as a protocol to use for appropriate hydration of the avian patient. Raptors are used as a model in this article; however, these techniques and supporting information can easily be applied to most avian species. [Copyright &y& Elsevier]