Description of a new non‐injectable connector to reduce the complications of arterial blood sampling
| Autor: | Paul J Young, James Richardson, C. A. Maduakor, M Mariyaselvam, D. Laba, R. E. Heij, J. J. Carter, Emily Hodges |
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| Rok vydání: | 2014 |
| Předmět: |
Atropine
medicine.medical_specialty Critical Care medicine.medical_treatment Manikins Arterial cannulation law.invention Catheters Indwelling Intravenous cannula Bacterial colonization law medicine Humans New device Syringe Blood Specimen Collection Cross Infection Medical Audit Bacteria business.industry Syringes Equipment Design Intensive care unit Surgery Anesthesiology and Pain Medicine Arterial blood sampling Equipment Contamination business Anti-Arrhythmia Agents Central venous catheter |
| Zdroj: | Anaesthesia. 70:51-55 |
| ISSN: | 1365-2044 0003-2409 |
| DOI: | 10.1111/anae.12884 |
| Popis: | Summary Arterial cannulation is associated with complications including bacterial contamination, accidental intra-arterial injection and blood spillage. We performed a series of audits and experiments to gauge the potential for these, as well as assess the possible contribution of a new device, the Needle-Free Arterial Non-Injectable Connector (NIC), in reducing these risks. The NIC comprises a needle-free connector that prevents blood spillage and a one-way valve allowing aspiration only; once screwed onto the side port of a three-way tap, the device can only be removed with difficulty. We performed a clinical audit of arterial monitoring systems in our intensive care unit, which showed an incidence of bacterial colonisation of five in 86 (6%) three-way tap ports. We constructed a manikin simulation experiment of the management of acute bradycardia, in which trainee doctors were required to inject atropine intravenously. Ten of 15 (66%) doctors injected the drug into the three-way tap of the arterial monitoring system rather than into the intravenous cannula or the central venous catheter. In a laboratory study, we replicated the arterial blood sampling and flushing sequence from a three-way tap, with the syringes attached either directly to the threeway tap port or to a NIC attached to the port. The first (discard) syringe attached to the three-way tap was contaminated with bacteria. Bacterial growth was found in 17 of 20 (85%) downstream flushed samples (corresponding to the patient’s circulation) when the three-way tap was accessed directly, compared to none of 20 accessed via the NIC (p < 0.0001). Growth was found on all of 20 (100%) ports accessed directly compared to none of 20 accessed via the NIC (p < 0.0001). The NIC effectively prevents bacteria from contaminating sampling lines. As its design also prevents accidental intra-arterial injection, we suggest that it can reduce complications of arterial monitoring. |
| Databáze: | OpenAIRE |
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