Zarate Ligia, Mandleco Barbara, Wilshaw Russell, Ravert Patricia
Utah Valley Regional Medical Center, Provo, Utah, USA.
J Trauma Nurs. 2008 Apr-Jun;15(2):47-52. doi: 10.1097/01.JTN.0000327326.83276.ce.
The purpose of this study was to determine the rates of phlebitis in trauma patients according to where the peripheral intravenous catheter (PIVC) was inserted in a prehospital setting or in an emergency department setting. Variables investigated also included where the catheter was anatomically placed, the gauge of the catheter, and the patients' Injury Severity Score. The overall phlebitis rate was 5.79%. The rate of phlebitis was 2.92% when started by an RN in the emergency department, 6.09% when started by an intermediate emergency medical technician and 7.78% when started by a paramedic in prehospital setting. There was no significant difference in the rates of phlebitis when a chi-square analysis was performed. In addition, no variables predicted phlebitis no matter where the PIVC was started when a regression analysis was conducted. Even though the Centers for Disease Control and Prevention suggests removing the PIVC within 48 hours if placed under emergency situations, the phlebitis rates of trauma patients in this study meet the benchmark of best practice. Perhaps removing the PIVC within 48 hours of placement should be reconsidered.
本研究的目的是根据外周静脉导管(PIVC)在院前环境或急诊科环境中的插入位置,确定创伤患者的静脉炎发生率。所调查的变量还包括导管在解剖学上的放置位置、导管的规格以及患者的损伤严重程度评分。总体静脉炎发生率为5.79%。在急诊科由注册护士开始置管时静脉炎发生率为2.92%,由中级急救医疗技术人员开始置管时为6.09%,在院前环境由护理人员开始置管时为7.78%。进行卡方分析时,静脉炎发生率无显著差异。此外,进行回归分析时,无论PIVC从何处开始置管,均无变量可预测静脉炎。尽管疾病控制与预防中心建议在紧急情况下放置的PIVC应在48小时内拔除,但本研究中创伤患者的静脉炎发生率符合最佳实践基准。或许应重新考虑在置管后48小时内拔除PIVC。