Contrast Extravasation as a Complication of Emergency Nurse-Performed Ultrasound-Guided Peripheral Intravenous Catheter Placement
| Autor: | Robert Wells, John Z. Gallien, Adrienne Malik, Adam Kasten, Robert R. Ehrman, Mark Favot |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Population Emergency Nursing Nursing Staff Hospital 03 medical and health sciences 0302 clinical medicine Catheterization Peripheral medicine Humans 030212 general & internal medicine education Ultrasonography Interventional Retrospective Studies education.field_of_study business.industry Ultrasound Absolute risk reduction 030208 emergency & critical care medicine Emergency department Confidence interval Exact test Relative risk Radiology Complication business Extravasation of Diagnostic and Therapeutic Materials |
| Zdroj: | Journal of emergency nursing. 45(5) |
| ISSN: | 1527-2966 |
| Popis: | Introduction Vascular access procedures are among the most commonly performed procedures in the emergency department. The objective of the current study was to compare the contrast extravasation rate for ultrasound-guided peripheral intravenous (USGPIV) catheter placement by emergency nurses with peripheral intravenous catheters placed by standard landmark techniques. Methods A retrospective chart review of all ED patients at our urban tertiary-care institution who underwent contrasted computed tomography examination and suffered contrast extravasation events was performed. A logbook of all ED patients who underwent USGPIV placement and an institution-wide electronic patient safety incident-reporting system was reviewed for all contrast extravasation events between May 2014, and February 2017. Data were analyzed using descriptive statistics, Student t-tests for continuous data, and χ2 or Fisher's exact test for categorical data. Results One thousand five hundred USGPIV catheters were placed by 27 emergency nurses. Contrast material was administered 29,508 times, and, of these, 291 were administered via USGPIV placement. There were 74 peripheral IV lines with documented contrast extravasations (0.25%) as reported in the safety-event database; 12 (4.1%) were from the USGPIV population, and 62 (0.21%) occurred in the standard landmark technique population. Relative risk of contrast extravasation events with USGPIV placement was 19.4 (95% confidence interval [CI], 10.6-35.6), and the absolute risk difference was 3.9% (95% CI 1.6%-6.2%). Discussion USGPIV placement by trained emergency nurses has higher rates of contrast extravasation than with standard landmark technique placement. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect