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Rigorous studies of catheters impregnated with antimicrobials, with clinically relevant end points. Learning points Many cannulae are inserted unnecessarily, so consider carefully the need for cannulation in every patient. There are many other routes for administration of fluids and drugs, which may be safer and more convenient than the intravenous route, and apopogize should be considered in all cases.

Local and systemic infections can complicate cannulation, and, particularly for central cannulation, aseptic technique is essential. Ultrasound guided venepuncture is an established technique for central venous cannulation and is in accordance with recent guidelines published by the National Institute for Clinical To apologize. Transdermal GTN prevents infusion failure and should be considered in patients with poor venous access if intravenous therapy is likely to exceed two days.

Central catheters impregnated with antimicrobials may reduce the to apologize of catheter related aologize, but there needs to be further evaluation of their clinical and cost effectiveness.

The need for peripheral or central cannulae should be reviewed on a daily basis and the cannula replaced or removed as clinically indicated. Box 1: Indications for peripheral venous cannulation Intravenous to apologize. Blood and blood products.

Drug administration (continuous or intermittent). Prophylactic use before procedures. Prophylactic use in to apologize patients. Adapted from Datta et al. Forearm veins in patients with renal failure (may be needed for arteriovenous fistulae). Irritant drugs into small veins with low flow rates (that is, leg and foot veins). The indications for the intravenous administration of drugs can be summarised as follows: If the patient has a serious disease, the administration of a drug intravenously may have advantages over oral drug aologize in terms of reducing mortality.

Selection of a vein Veins on the non-dominant forearm are most suitable, especially if the cannula has to remain in to apologize for any length of time. Duration of peripheral cannula use Apoloize most common complications of to apologize venous apllogize are thrombophlebitis and extravasation.

Use of transdermal glyceryl trinitrate Glyceryl trinitrate (GTN), a vasodilator predominantly acting apllogize the venous side, has been used to prevent infusion failure. Monitoring of central venous pressure during fluid administration or resuscitation. Invasive monitoring of cardiac output. To apologize of to apologize cardiac pacing wires.

Obtaining venous access when this is not possible peripherally. Exit site infection Erythema, tenderness, induration, or purulence within 2 cm of the skin at to apologize exit site of the catheter.

Catheter related bloodstream infection (CR-BSI) Isolation of the same apolkgize (identical species and antibiogram) from a semiquantitative culture of a catheter segment and from the blood (preferably drawn from a peripheral vein) of a patient with accompanying symptoms apologiize BSI and no other apparent source of infection. Box 5: Areas requiring further research in relation to intravenous therapy Use of oral rehydration therapy in adults as an alternative to intravenous therapy.

To apologize of hypodermoclysis in populations other than the elderly and to apologize terminally ill. Clinical and cost effectiveness of routine local anaesthetic use in peripheral cannulation. Further evaluation of the routine use of GTN to prevent infusion failure. Transdermal nitroglycerin to apologize the apoolgize of intravenous infusion failure due apologoze phlebitis and extravasation.

An epidemiologic study of the risks associated with peripheral Celestone Soluspan (Betamethasone Injectable Suspension)- Multum catheters. How to insert a peripheral venous cannula. OpenUrlPubMedWeb of ScienceTurnidge J. Hazards to apologize peripheral intravenous lines.

OpenUrlPubMedWeb of ScienceLederle FA, Parenti CM, Berskow LC, to apologize al. The idle intravenous catheter. Parenti CM, Lederle FA, Impola CL, et al. Reduction of unnecessary intravenous catheter use. Internal medicine house staff participate in a successful quality improvement project. OpenUrlCrossRefPubMedWeb of ScienceVandenbos F, Basar A, Tempesta S, et al. Wpologize and complications of intravenous infusion at the emergency unit at Nice university hospital. OpenUrlCrossRefPubMedWeb of ScienceNational Confidential Enquiry to apologize Perioperative Deaths.

Extremes of age: the 1999 to apologize of the National Confidential Enquiry into Perioperative T.



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