응급실 소아환자의 정맥로 확보: 누가 그리고 어디에?
Establishment of peripheral intravenous catheter for pediatric patients in the emergency department: who and how?
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
.
Abstract
Purpose Peripheral intravenous cannulation (PIC) for children is technically difficult. We aimed to investigate factors associated with the primary success of PIC for children in the emergency department (ED). Methods This prospective observational study was conducted on children younger than 3 years who visited the ED from September 2014 to August 2015. The children undergoing primary success, defined as success at the first attempt, comprised the success group. Using a case report form, information about the children (age, sex, and weight), practitioners’ occupation (doctors, nurses, emergency medical technicians [EMTs]), treatment venue, insertion site of PIC, presence of guardians, and use of auxiliary devices were collected and compared between the success and failure groups. Multivariable logistic regression models were constructed to identify factors associated with the primary success. Results Of 439 children, 271 underwent the primary success (61.7%). The success group showed older age, heavier weight, and higher proportion of EMT. No differences were found in treatment venue, insertion site, and presence of the guardian. We found that patients’ age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.003-1.1), and practitioners’ occupation (EMT; OR, 3.0; 95% CI, 1.9-4.7, compared with doctors) were the factors associated with the primary success. Conclusion Practitioners’ occupation (EMT) and children’s age (older) may be associated with the primary success of PIC. It may be helpful to have specialized personnel when performing PIC on children in the ED.
참고문헌 (15)
- Jacobson AF, "Variables influencing intravenous catheter insertion difficulty and failure: an analysis of 339intravenous catheter insertions", Heart Lung, 34, pp.345~359 (2005)
- Cosentino F, "I can start that I.V. with one attempt", NITA, 7, pp.377~378 (1984)
- Lapostolle F, "Prospective evaluation of peripheral venous access difficulty in emergency care", Intensive Care Med, 33, pp.1452~1457 (2007)
- Carr PJ, "Insertion of peripheral intravenous cannulae in the Emergency Department: factors associated with firsttime insertion success", J Vasc Access, 17, pp.182~190 (2016)
- Heinrichs J, "A systematic review and meta-analysis of new interventions for peripheral intravenous cannulation of children", Pediatr Emerg Care, 29, pp.858~866 (2013)
- Reigart JR, "Peripheral intravenous access in pediatric inpatients", Clin Pediatr (Phila), 51, pp.468~472 (2012)
- Legemaat M, "Peripheral intravenous cannulation: complication rates in the neonatal population:a multicenter observational study", J Vasc Access, 17, pp.360~365 (2016)
- Cummings EA, "Prevalence and source of pain in pediatric inpatients", Pain, 68, pp.25~31 (1996)
- Frey AM, "Success rates for peripheral i.v. insertion in a children’s hospital. Financial implications", J Intraven Nurs, 21, pp.160~165 (1998)
- Cuper NJ, "Predictive factors for difficult intravenous cannulation in pediatric patients at a tertiary pediatric hospital", Paediatr Anaesth, 22, pp.223~229 (2012)
- Lenhardt R, "Local warming and insertion of peripheral venous cannulas:single blinded prospective randomised controlled trial and single blinded randomised crossover trial", BMJ, 325, pp.409~410 (2002)
- Huff L, "Atraumatic care: EMLA cream and application of heat to facilitate peripheral venous cannulation in children", Issues Compr Pediatr Nurs, 32, pp.65~76 (2009)
- Maynard EC, "Topical nitroglycerin ointment as an aid to insertion of peripheral venous catheters in neonates", J Pediatr, 114, pp.474~476 (1989)
- Andrew M, "The use of glyceryl trinitrate ointment with EMLA cream for i.v. cannulation in children undergoing routine surgery", Anaesth Intensive Care, 30, pp.321~325 (2002)
- Kuhns LR, "Intense transillumination for infant venipuncture", Radiology, 116, pp.734~735 (1975)