Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Look up keyword
Like this
5Activity
0 of .
Results for:
No results containing your search query
P. 1
How Safe Are IV Cannula

How Safe Are IV Cannula

Ratings:

5.0

(2)
|Views: 3,291 |Likes:
Work done in Winchester and Eastleigh Healthcare NHS Trust (UK) now prove IV Cannula is associated with invasive MRSA. This raises an important question, “How safe are these device”, is it safe to insert one?, knowing the procedure can result in mortality. How can this be different from drug administration? And as doctors what can we do?
Work done in Winchester and Eastleigh Healthcare NHS Trust (UK) now prove IV Cannula is associated with invasive MRSA. This raises an important question, “How safe are these device”, is it safe to insert one?, knowing the procedure can result in mortality. How can this be different from drug administration? And as doctors what can we do?

More info:

Published by: Dr Kadiyali M Srivatsa on Jun 16, 2008
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PDF, TXT or read online from Scribd
See more
See less

09/06/2012

pdf

text

original

 
Abstract
Winchester and Eastleigh Healthcare NHS Trust (UK) begun prescribing the insertion of intra-vascular device (cannula) and reduced MRSA infection by 100%. This work provesbeyond doubt the association of intra-vascular device with increased infection rate inhospitals.Multiple punctures put patients at risk for local and systemic infectious complications,including local site infection. IVD can now be classified similar to a classified drug as its usecan result in serious harm to the patients. This may result in the introduction the organismpresent on the skin, resulting in severe toxemia & shock, and possible death. As doctors wemust respect our ethics and ask this question “Is this cannula safe?” How do we defend our action ?
Introduction
Winchester and Eastleigh Healthcare NHS Trust (UK) (BBC News, 8
th
May 2008) begunprescribing the insertion of intra-vascular device (cannula). Doctors were able to monitor the tubes more closely for signs of infection. Since the introduction of this protocol lastNovember there have been no new cases of MRSA infections. This figure covers all formsof MRSA, including bacteraemia and wound infections. This compares to 2007/08 whenthere was 11 reported bloodstream infections. This work proves beyond doubt theassociation of intra-vascular device with increased infection rate in hospitals.The emergence of new epidemic strains of CA-MRSA in the community, among patientswithout established MRSA risk factors, may present new challenges to MRSA control inhealthcare settings(1). Klevens RM et al; reported Invasive MRSA is a major public healthproblem primarily related to health care but no longer confined to intensive care units, acutecare hospitals, or any health care institution (2).
et al; published the result of their study CA-MRSA Hand Infections in an Urban Setting, claiming 73% of healthy adultsare said to carry this organism on their hands(3)
 
Doctors, patients and healthcare workers must look carefully at various procedures carriedout in hospitals. We have been taking a close look at the most common procedures per-formed in modern-day medical practice is insertion of intravenous cannulation – is hated byall. As house officers claim the success of inserting a cannula is the first attempt is about60% and rate improved to 90% as seniors doctor (4)Multiple punctures put patients at risk for local and systemic infectious complications,including local site infection. Peripheral venous catheters / cannulae are the devices mostfrequently used for vascular access. Although the incidence of local or bloodstreaminfections (BSIs) associated with peripheral venous catheters was said to be low. Now dueto serious infectious complications produce considerable annual morbidity because of thefrequency with which such catheters are used.PVCs inserted in the emergency department caused the highest number of episodes andhad a shorter duration to bacteraemia than those inserted in other hospital areas. This isprobably due to the fact that in the emergency department, PVCs are used excessively andare frequently inserted under poor aseptic conditions (5). Unsuccessful attempts not onlycause distress to the patient and make cannulation more difficult, but each unnecessarypuncture wound provides an access route for MRSA or other drug-resistant organisms intothe bloodstream. The CDC and the UK Department of Health have addressed this issue byrecommending that all PVCs inserted in emergency situations must be removed or changedon hospital wards within the first 48 h of admission and every 72 h irrespective of the pres-ence of infection.(6). Ward nurses are, however, highly reluctant to change recently insert-ed vascular catheters. Furthermore, other studies have been unable to demonstrate an in-creased risk of complications after three days of peripheral vascular catheterisation andhave questioned the CDC recommendation for the routine replacement of PVCs. (7)The various guidelines advise healthcare professionals to use the hand to place an intra-vascular device. Avoid the routine use of the veins of the lower extremities due to the in-creased risk of embolism, thrombophlebitis of and infection (8). These studies were carriedout in intensive care settings and were based on central venous catheters (CVC). CDC haspublished their guidelines on hand hygiene in health care in their website, and this will soonneed updating based on the present information.In September 2007, Spanish doctors published a paper and concluded the incidence of bacteria associated staphylococcus infection of blood is more common in patients havingan Intra-venous Device (IVD) administered in ER and said to occur within 48 hours (5).Crnich, CJ et al assessed the risk of bloodstream
 
Infection in adults with different intravascular devices and published their result in MayoClinic Proceedings: The results show that all types of IVDs pose a risk of bloodstreaminfection (BSI) and can be used for benchmarking rates of infection caused by the varioustypes of IVDs in use at the present time (9).Since almost all the national effort and progress to date to reduce the risk of IVD-relatedinfection has focused on short-term no cuffed IVD as used in hospitals; infection controlprograms must now strive to consistently apply essential control measures and preventivetechnologies with all types of IVD’s.There are very convincing reports from respected institutions that will make doctors feelvery uncomfortable in introducing cannulae in healthy adults. IVD can now be classifiedsimilar to a classified drug as its use can result in serious harm to the patients. The cleaningsolution may not be as effective as claimed. This may result in the introduction theorganism present on the skin, resulting in severe toxemia & shock, and possible death of the patients within 48 hours. As doctors we must respect our ethics and ask this question“Is this cannula safe?” How do we defend our action when a patient dies from an ICU-acquired infection related to methicillin-resistant Staphylococcus aureus (10)?We have identified several potential causes that need updating. Use of non-sterile or sterilegloves, use of ported cannula, problems with cleaning solutions, introduction techniques,failure rates and fixation of devices to be the important factors requiring further assessment.

Activity (5)

You've already reviewed this. Edit your review.
1 hundred reads
1 thousand reads
cannula liked this
cannula liked this
nikuni123 liked this

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->