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Jeon K, Han SB, Kym D, Kim M, Park J, Yoon J, Hur J, Cho YS, Chun W. Central venous catheter tip colonization and associated bloodstream infection in patients with severe burns under routine catheter changing. Am J Infect Control 2024; 52:813-818. [PMID: 38355049 DOI: 10.1016/j.ajic.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Although routine changing of central venous catheters (CVCs) is commonly performed in patients with severe burns, information on pathogen colonization of the CVC tip and associated bloodstream infections (BSIs) is limited in those patients. METHODS The medical records of 214 patients with severe burns who underwent routine CVC changing at 7-day intervals and their results of 686 pairs of CVC tips and concurrent blood cultures were retrospectively reviewed to evaluate the CVC colonization rate and associated BSI pathogens. RESULTS Of the 686 CVCs, 137 (20.0%) were colonized by pathogens, and 81 (59.1%) of them had BSIs caused by the same pathogen. Nonflame burn (P = .002), total body surface area burn ≥30% (P = .004), femoral catheterization (P = .001), CVC changing during pre-existing BSI (P < .001), and renal replacement therapy (P = .017) were associated with catheter-related BSI in the multivariate analysis. Most BSIs were caused by Gram-negative bacteria (most commonly Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa). CONCLUSIONS The CVC colonization rate in patients with severe burns and routine CVC changing was not high. Lengthening the CVC duration might be attempted in patients at a lower risk of catheter-related BSI although further prospective studies are necessary.
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Affiliation(s)
- Kibum Jeon
- Infection Prevention and Control Unit, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea; Department of Laboratory Medicine, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea
| | - Seung Beom Han
- Infection Prevention and Control Unit, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea; Department of Pediatrics, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea.
| | - Dohern Kym
- Infection Prevention and Control Unit, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea; Department of Surgery and Critical care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea
| | - Myongjin Kim
- Department of Surgery and Critical care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea
| | - Jongsoo Park
- Department of Surgery and Critical care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea
| | - Jaechul Yoon
- Department of Surgery and Critical care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea
| | - Jun Hur
- Department of Surgery and Critical care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea
| | - Yong Suk Cho
- Department of Surgery and Critical care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea
| | - Wook Chun
- Department of Surgery and Critical care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea
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Anderson DI, Fordyce EM, Vrouwe SQ. The Quality of Survey Research in Burn Care: A Systematic Review. Burns 2022; 48:1825-1835. [DOI: 10.1016/j.burns.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/29/2021] [Accepted: 01/16/2022] [Indexed: 11/02/2022]
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Hanson LM, Bettencourt AP. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Guide for Nurses. AACN Adv Crit Care 2021; 31:281-295. [PMID: 32866260 DOI: 10.4037/aacnacc2020634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Nurses are central to the care of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. Patients with these conditions present with nuanced symptoms and have complex nursing care needs. Although much of the exact pathophysiology of these diseases is not known, all nurses benefit from a fundamental understanding of the genesis of skin manifestations, associated pharmacology, and prognosis. The care of patients hospitalized with Stevens-Johnson syndrome and toxic epidermal necrolysis consists of wound care, infection prevention, comfort management, hydration and nutrition, psychosocial support, and the prevention of long-term complications. This article provides an overview of these diseases, including clinical diagnosis, history and physical assessment, related pharmacology, and nursing care priorities. A description of the current state of the science in clinical management for nurses at all levels is provided, with an emphasis on nursing's contribution to the best possible patient outcomes.
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Affiliation(s)
- Leah M Hanson
- Leah M. Hanson is Decentralized Nurse Educator, Burn Center, Regions Hospital, St Paul, Minnesota
| | - Amanda P Bettencourt
- Amanda P Bettencourt is Research Fellow, NCSP, and TACTICAL Scholar, Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, North Campus Research Center, 2800 Plymouth Rd, B14, Suite G-100, Ann Arbor, MI 48109
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Yokota T, Tokumine J, Lefor AK, Hasegawa A, Yorozu T, Asao T. Ultrasound-guided placement of a midline catheter in a patient with extensive postburn contractures: A Case report. Medicine (Baltimore) 2019; 98:e14208. [PMID: 30653177 PMCID: PMC6370112 DOI: 10.1097/md.0000000000014208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Obtaining venous access in a patient with extensive postburn scar contractures is a challenge. PATIENT CONCERNS A 39-year-old woman suffered a burn 2 years previously with a total body surface area burn of 93%, and a burn index of 85. Reconstructive surgery was previously performed 39 times. Split-thickness skin grafting to the neck was planned. She had no accessible peripheral veins. DIAGNOSIS Difficult venous access due to excessive burn scar contractures. INTERVENTIONS Central venous catheterization was considered impossible even with ultrasound guidance. We placed a midline catheter for intraoperative venous access in a patient with extensive burn scar contractures. The midline catheter is a peripheral venous catheter placed in an arm vein. OUTCOMES We successfully placed a midline catheter in the right brachial vein. This catheter was used for 24 days without difficulty. LESSONS The midline catheter is a viable choice in patients with difficult vascular access due to extensive postburn scar contractures.
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Affiliation(s)
- Taisuke Yokota
- Department of Anesthesiology, Kyorin University School of Medicine, Tokyo
| | - Joho Tokumine
- Department of Anesthesiology, Kyorin University School of Medicine, Tokyo
| | | | - Ayako Hasegawa
- Department of Anesthesiology, Kyorin University School of Medicine, Tokyo
| | - Tomoko Yorozu
- Department of Anesthesiology, Kyorin University School of Medicine, Tokyo
| | - Takayuki Asao
- Big Data Center for Integrative Analysis, Gunma University Initiative for Advanced Research, Maebashi, Gunma, Japan
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Xu L, Zhu Y, Yu J, Deng M, Zhu X. Nursing care of a boy seriously infected with Steven-Johnson syndrome after treatment with azithromycin: A case report and literature review. Medicine (Baltimore) 2018; 97:e9112. [PMID: 29505509 PMCID: PMC5943129 DOI: 10.1097/md.0000000000009112] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Stevens-Johnson syndrome (SJS) is an acute blistering disease of the skin and mucous membranes. SJS in children is not common but potentially serious disease. But the epidemiology of SJS in China is not well defined. PATIENT CONCERNS A 6-year-old boy was initially diagnosed as pneumonia admitted to hospital after admission, and the body appears red rash with blisters, skin damage, lip debaucjed, repeated high fever, and rapid progression. DIAGNOSES SJS often results from an allergy reaction response to a range of drugs. It is a clinical diagnosis suggested by fever and malaise followed by an extensive painful, nonblanching, macular rash that commonly progresses to blistering or sloughing, and mucositis. INTERVENTIONS The boy was treated with continuous renal replacement therapy, anti-infection therapy, high-dose glucocorticoid treatment, and symptomatic treatment. OUTCOMES The patient was recovered after 33 days of treatment. LESSONS The current treatment is mainly symptomatic treatment, and for the patient, it is important to make skin care related well, included early out blisters at effusion, reducing skin ulceration of the mucosa area, keeping skin clean, removing mucosa secretion and blood clots, doing eye care related, preventing the complications, ensuring adequate intake of nutrition and warm and so on.
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Use of Implementation Science for a Sustained Reduction of Central-Line-Associated Bloodstream Infections in a High-Volume, Regional Burn Unit. Infect Control Hosp Epidemiol 2017; 38:1306-1311. [PMID: 28899444 DOI: 10.1017/ice.2017.191] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE We describe the use of implementation science at the unit level and organizational level to guide an intervention to reduce central-line-associated bloodstream infections (CLABSIs) in a high-volume, regional, burn intensive care unit (BICU). DESIGN A single center observational quasi-experimental study. SETTING A regional BICU in Maryland serving 300-400 burn patients annually. INTERVENTIONS In 2011, an organizational-level and unit-level intervention was implemented to reduce the rates of CLABSI in a high-risk patient population in the BICU. At the organization level, leaders declared a goal of zero infections, created an infrastructure to support improvement efforts by creating a coordinating team, and engaged bedside staff. Performance data were transparently shared. At the unit level, the Comprehensive Unit-based Safety Program (CUSP)/ Translating Research Into Practice (TRIP) model was used. A series of interventions were implemented: development of new blood culture procurement criteria, implementation of chlorhexidine bathing and chlorhexidine dressings, use of alcohol impregnated caps, routine performance of root-cause analysis with executive engagement, and routine central venous catheter changes. RESULTS The use of an implementation science framework to guide multiple interventions resulted in the reduction of CLABSI rates from 15.5 per 1,000 central-line days to zero with a sustained rate of zero CLABSIs over 3 years (rate difference, 15.5; 95% confidence interval, 8.54-22.48). CONCLUSIONS CLABSIs in high-risk units may be preventable with the a use a structured organizational and unit-level paradigm. Infect Control Hosp Epidemiol 2017;38:1306-1311.
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Dale EL, Hultman CS. Patient Safety in Burn Care: Application of Evidence-based Medicine to Improve Outcomes. Clin Plast Surg 2017; 44:611-618. [PMID: 28576250 DOI: 10.1016/j.cps.2017.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This article reviews 5 areas in burn care that increasingly use evidence-based medicine to optimize quality and safety: resuscitation protocols, transfusion practices, vascular access, venous thromboembolic prophylaxis, and rational use of antibiotics.
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Affiliation(s)
- Elizabeth L Dale
- Division of Plastic/Burn Surgery, Shriners Hospital for Children, University of Cincinnati, 231 Albert Sabin Way, Academic Health Center, Cincinnati, OH 45267-0513, USA.
| | - Charles Scott Hultman
- Division of Plastic Surgery, Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Prävention von Infektionen, die von Gefäßkathetern ausgehen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 60:171-206. [DOI: 10.1007/s00103-016-2487-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Soni NJ, Reyes LF, Keyt H, Arango A, Gelfond JA, Peters JI, Levine SM, Adams SG, Restrepo MI. Use of ultrasound guidance for central venous catheterization: a national survey of intensivists and hospitalists. J Crit Care 2016; 36:277-283. [PMID: 27491563 DOI: 10.1016/j.jcrc.2016.07.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/28/2016] [Accepted: 07/05/2016] [Indexed: 02/07/2023]
Abstract
PURPOSE The purpose of the study is to evaluate the frequency and barriers to use of ultrasound guidance for central venous catheter (CVC) insertion by physicians specializing in critical care and hospital medicine. MATERIALS AND METHODS A national cross-sectional electronic survey of intensivists and hospitalists was administered from November 2014 to January 2015. RESULTS The survey response rate was 5.9% (1013/17 233). Moderate to very frequent use of ultrasound guidance varied by site: internal jugular vein (80%), subclavian vein (31%), and femoral vein (45%). Nearly all physicians (99%) who insert internal jugular CVCs daily use ultrasound guidance, whereas only 46% of physicians who insert subclavian CVCs daily use ultrasound guidance. Use of real-time ultrasound guidance varied by insertion site: internal jugular vein (73%), subclavian vein (28%), and femoral vein (42%). Most physicians (59%) reported not being comfortable with real-time needle tracking at the subclavian site. The most frequently reported barriers to use of ultrasound guidance were (1) limited availability of ultrasound equipment (28%), (2) perception of increased total procedure time (22%), and (3) concern for loss of landmark skills (13%). CONCLUSIONS Most intensivists routinely use ultrasound guidance to insert internal jugular CVCs but not subclavian CVCs. The most commonly reported barrier to ultrasound use was limited access to an ultrasound machine.
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Affiliation(s)
- Nilam J Soni
- Division of Hospital Medicine, University of Texas School of Medicine in San Antonio, TX 78229; Division of Pulmonary and Critical Care Medicine, University of Texas School of Medicine in San Antonio, TX 78229; Section of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX 78229.
| | - Luis F Reyes
- Division of Pulmonary and Critical Care Medicine, University of Texas School of Medicine in San Antonio, TX 78229
| | - Holly Keyt
- Division of Pulmonary and Critical Care Medicine, University of Texas School of Medicine in San Antonio, TX 78229; Section of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX 78229
| | - Alejandro Arango
- Department of Oral & Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA 02114
| | - Jonathan A Gelfond
- Department of Epidemiology & Biostatistics, University of Texas Health Science Center, San Antonio, TX 78229
| | - Jay I Peters
- Division of Pulmonary and Critical Care Medicine, University of Texas School of Medicine in San Antonio, TX 78229; Section of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX 78229
| | - Stephanie M Levine
- Division of Pulmonary and Critical Care Medicine, University of Texas School of Medicine in San Antonio, TX 78229; Section of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX 78229
| | - Sandra G Adams
- Division of Pulmonary and Critical Care Medicine, University of Texas School of Medicine in San Antonio, TX 78229; Section of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX 78229
| | - Marcos I Restrepo
- Division of Pulmonary and Critical Care Medicine, University of Texas School of Medicine in San Antonio, TX 78229; Section of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX 78229
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Song C, Oh H. Burn patients’ experience of peripherally inserted central catheter insertion: Analysis of focus group interviews from a South Korean burn center. Burns 2016; 42:1439-1444. [DOI: 10.1016/j.burns.2016.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/06/2016] [Accepted: 04/07/2016] [Indexed: 01/06/2023]
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Retrospective Data about the Catheter-related Complications and Management in Massive Bus Burn Casualties. J Vasc Access 2016; 17:353-9. [PMID: 27056030 DOI: 10.5301/jva.5000547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2016] [Indexed: 11/20/2022] Open
Abstract
Purpose This is a single-center, descriptive report of the management and complications of venous catheter use in 19 severely burned passengers from a bus fire that occurred on July 5, 2014, in Hangzhou. Methods We recorded the parameters of the catheters insertion and indwelling. Sampling of each removed catheter was conducted to monitor for catheter-related infections. Bedside ultrasound screening was performed for recording central venous catheter (CVC)-related complications. Results Of the 174 venous accesses placed, 108 were CVCs. 27 (25.0%) catheter tip cultures (CTC) were positive; 12 (11.1%) were catheter-related blood stream infections (CRBSI). Acinetobacter baumannii was the most prominent bacterial infection for both CTC- (55.56%) and CRBSI- (75.00%) positive catheters. CTC- and CRBSI-positive rates were higher during the emergency stage, and both dropped rapidly after reform measures (chi-square test, p = 0.003), and all were negative after the no. 8 catheters. Accumulative regression results indicated that total body surface area burned (TBSA), number of catheters, days of indwelling, and bloodstream infections were independently associated with CTC results, while gender and number of catheters were independently associated with CRBSI results. 1 femur vein thrombosis was detected and cured. Conclusions Bedside ultrasound and professional IV team for CVC management are pivotal for massive burn victims. Their intervention helps control CVC-related infections and other complications. A. baumannii was the most frequent bacterial infection found in both CTC- and CRBSI-positive catheters. Several most important factors associated with catheter-related infections were concluded. This information alerts us to watch for patients with such warning factors.
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Tempe D, Hasija S, Saigal D, Sanwal M, Virmani S, Satyarthi S. Comparison of the landmark technique and the static ultrasound-guided technique for internal jugular vein cannulation in adult cardiac surgical patients. MAMC JOURNAL OF MEDICAL SCIENCES 2016. [DOI: 10.4103/2394-7438.182719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tao L, Zhou J, Gong Y, Liu W, Long T, Huang X, Luo G, Peng Y, Wu J. Risk factors for central line-associated bloodstream infection in patients with major burns and the efficacy of the topical application of mupirocin at the central venous catheter exit site. Burns 2015; 41:1831-1838. [DOI: 10.1016/j.burns.2015.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 07/26/2015] [Accepted: 08/08/2015] [Indexed: 10/23/2022]
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Peripherally inserted central venous catheter safety in burn care: a single-center retrospective cohort review. J Burn Care Res 2015; 36:111-7. [PMID: 25501778 DOI: 10.1097/bcr.0000000000000207] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The use of peripherally inserted central catheter (PICC) line for central venous access in thermally injured patients has increased in recent years despite a lack of evidence regarding safety in this patient population. A recent survey of invasive catheter practices among 44 burn centers in the United States found that 37% of burn units use PICC lines as part of their treatment protocol. The goal of this study was to compare PICC-associated complication rates with the existing literature in both the critical care and burn settings. The methodology involved is a single institution retrospective cohort review of patients who received a PICC line during admission to a regional burn unit between 2008 and 2013. Fifty-three patients were identified with a total of seventy-three PICC lines. The primary outcome measurement for this study was indication for PICC line discontinuation. The most common reason for PICC line discontinuation was that the line was no longer indicated (45.2%). Four cases of symptomatic upper extremity deep vein thrombosis (5.5%) and three cases of central line-associated bloodstream infection (4.3%, 2.72 infections per 1000 line days) were identified. PICC lines were in situ an average of 15 days (range 1 to 49 days). We suggest that PICC line-associated complication rates are similar to those published in the critical care literature. Though these rates are higher than those published in the burn literature, they are similar to central venous catheter-associated complication rates. While PICC lines can be a useful resource in the treatment of the thermally injured patient, they are associated with significant and potentially fatal risks.
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Younghwan C, Changmin S, Eunok P, Oh H. Use of blind placements of peripherally inserted central catheters in burn patients: a retrospective analysis. Burns 2015; 41:1281-5. [PMID: 25665735 DOI: 10.1016/j.burns.2015.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/21/2014] [Accepted: 01/18/2015] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Safe and reliable vascular access is essential for the treatment and care of burn patients. Peripherally inserted central catheters (PICCs) are widely used for various groups of critically and chronically ill patients. However, the information about PICC use and management for burn patients is limited. METHODS The Institutional Review Board approved retrospective cohort chart review included all burn patients at a single center who received one or more PICCs (n=106). Blind PICCs were placed by an intravenous clinical nurse specialist (IV CNS). Data were collected from PICC records and included general demographics, as well as PICC insertions, management, and removals. RESULTS About 42% of cases were in the cubital vein, 39% in the basilar, 14% in the cephalic, and 3% in the brachial veins. In 75% of the cases, gauze dressing was identified as the primary form of routine PICC nursing care. About 62% of all patients had their dressings changed every 48h and 37.5% had dressings changed daily. The average length of time each PICC remained in place was 18.5 days. About 16% of the cases were identified as having PICC-related complications, including one infection, two occlusions (2%), one edema at insertion place (1%), and 12 cases of mechanical phlebitis. CONCLUSION Although PICCs are adequate for burn patient care, there are no protocols or guidelines covering rational and safe usage of PICCs. Standard guidelines on PICC placement and management specifically for burn patient should be developed.
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Affiliation(s)
| | | | - Park Eunok
- Bestian Burn Center, Daejeon, South Korea
| | - Hyunjin Oh
- Gachon University, Incheon, South Korea.
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Five-Lumen Antibiotic-Impregnated Femoral Central Venous Catheters in Severely Burned Patients. J Burn Care Res 2015; 36:493-9. [DOI: 10.1097/bcr.0000000000000186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Ferre RM, Mercier M. Novel ultrasound guidance system for real-time central venous cannulation: safety and efficacy. West J Emerg Med 2014; 15:536-40. [PMID: 25035764 PMCID: PMC4100864 DOI: 10.5811/westjem.2014.1.16305] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 10/15/2013] [Accepted: 01/27/2014] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Real-time ultrasound guidance is considered to be the standard of care for central venous access for non-emergent central lines. However, adoption has been slow, in part because of the technical challenges and time required to become proficient. The AxoTrack(®) system (Soma Access Systems, Greenville, SC) is a novel ultrasound guidance system recently cleared for human use by the United States Food and Drug Administration (FDA). METHODS After FDA clearance, the AxoTrack(®) system was released to three hospitals in the United States. Physicians and nurse practitioners who work in the intensive care unit or emergency department and who place central venous catheters were trained to use the AxoTrack(®) system. De-identified data about central lines placed in living patients with the AxoTrack(®) system was prospectively gathered at each of the three hospitals for quality assurance purposes. After institutional review board approval, we consolidated the data for the first five months of use for retrospective review. RESULTS The AxoTrack(®) system was used by 22 different health care providers in 50 consecutive patients undergoing central venous cannulation (CVC) from September 2012 to February 2013. All patients had successful CVC with the guidance of the AxoTrack(®) system. All but one patient (98%) had successful cannulation on the first site attempted. There were no reported complications, including pneumothorax, hemothorax, arterial puncture or arterial cannulation. CONCLUSION The AxoTrack(®) system was a safe and effective means of CVC that was used by a variety of health care practitioners.
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Affiliation(s)
- Robinson M. Ferre
- Vanderbilt University Medical Center, Department of Emergency Medicine, Nashville, Tennessee
| | - Mark Mercier
- Palmetto Health Baptist, Department of Emergency Medicine, Columbia, South Carolina
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Tempe DK, Malik I. Why do we not toe the line drawn by the National Institute for Clinical Excellence for internal jugular vein cannulation? Br J Anaesth 2014; 113:344-5. [PMID: 24875661 DOI: 10.1093/bja/aeu146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D K Tempe
- Department of Anaesthesiology and Intensive Care, Govind Ballabh Pant Hospital, Jawaharlal Nehru Road, New Delhi 110002, India Maulana Azad Medical College and Associated GB Pant, Loknayak and GNEC Hospitals, New Delhi, India
| | - I Malik
- Department of Anaesthesiology and Intensive Care, Govind Ballabh Pant Hospital, Jawaharlal Nehru Road, New Delhi 110002, India
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Ciofi Silva CL, Rossi LA, Canini SRMDS, Gonçalves N, Furuya RK. Site of catheter insertion in burn patients and infection: A systematic review. Burns 2014; 40:365-73. [DOI: 10.1016/j.burns.2013.10.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 10/25/2013] [Indexed: 11/16/2022]
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A Performance Improvement Initiative to Determine the Impact of Increasing the Time Interval Between Changing Centrally Placed Intravascular Catheters. J Burn Care Res 2014; 35:143-7. [DOI: 10.1097/bcr.0000000000000020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Approximately 2457 research articles were published with burns in the title, abstract, and/or keyword in 2012. This number continues to rise through the years; this article reviews those selected by the Editor of one of the major journals in the field (Burns) and his colleague that are most likely to have the greatest likelihood of affecting burn care treatment and understanding. As done previously, articles were found and divided into these topic areas: epidemiology of injury and burn prevention, wound and scar characterization, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation, long-term outcomes, and burn reconstruction. Each selected article is mentioned briefly with comment from the authors; readers are referred to the full papers for further details.
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Affiliation(s)
- Steven E Wolf
- Division of Burn, Trauma, and Critical Care, Department of Surgery, University of Texas - Southwestern Medical Center, Dallas, TX 75390-9158, United States.
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