Dumont C P
Division of Nursing, Shenandoah University, Va., USA.
Am J Crit Care. 2001 May;10(3):151-5.
Removal of internal jugular and subclavian central venous catheters is a common nursing intervention. Venous air embolism is a serious complication of catheter removal. Although some procedures have been recommended to prevent venous air embolism, whether nurses use these procedures and what complications patients experience are unknown.
The purposes of this pilot study were (1) to determine what procedures nurses use to remove internal jugular and subclavian central venous catheters, (2) to find out what complications patients are experiencing, (3) to find out if complications experienced are related to the procedures used, and (4) to develop a questionnaire about central venous catheters.
A descriptive and correlational design was used. The subjects were 29 nurses whose job description included removal of internal jugular and subclavian central venous catheters. Two questionnaires were used: a demographics questionnaire and the questionnaire about central venous catheters.
Descriptive statistics were used to analyze the sample, to determine the percentage of nurses sampled who use the recommended procedures, and to describe the frequency of complications observed. The sample size was not sufficient for observed complications to be correlated with procedures.
None of the nurses sampled had venous air embolism diagnosed in their patients. They reported observing dyspnea, pain, bleeding from the insertion site, and arrhythmias. Many of the nurses reported that they did not always use all the recommended procedures; only 9 nurses (31%) reported always using all the recommended procedures.
拔除颈内静脉和锁骨下中心静脉导管是一项常见的护理操作。静脉空气栓塞是导管拔除的严重并发症。尽管已推荐了一些预防静脉空气栓塞的操作,但护士是否采用这些操作以及患者会出现哪些并发症尚不清楚。
本初步研究的目的是:(1)确定护士拔除颈内静脉和锁骨下中心静脉导管时采用何种操作;(2)了解患者正在经历哪些并发症;(3)了解所经历的并发症是否与所采用的操作有关;(4)编制一份关于中心静脉导管的问卷。
采用描述性和相关性设计。研究对象为29名工作职责包括拔除颈内静脉和锁骨下中心静脉导管的护士。使用了两份问卷:一份人口统计学问卷和一份关于中心静脉导管的问卷。
采用描述性统计分析样本,确定采用推荐操作的抽样护士百分比,并描述观察到的并发症发生率。样本量不足以使观察到的并发症与操作相关联。
抽样护士的患者中均未诊断出静脉空气栓塞。他们报告观察到患者出现呼吸困难、疼痛、穿刺部位出血和心律失常。许多护士报告称他们并非总是采用所有推荐操作;只有9名护士(31%)报告始终采用所有推荐操作。