Infant peripherally inserted central catheter insertion without general anesthesia

Laing, Sarah; Burgoyne, Laura L.; Muncaster, Michele; Taranath, Ajay; Taverner, Fiona

doi:10.1111/pan.13950

Cited by 4 publications

(6 citation statements)

References 18 publications

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“…However, one study showed successful use of a "fast, feed and wrap" technique along with local anesthesia for peripherally inserted central catheter (PICC) placement. 13 The findings of this study are intriguing as they suggest this technique may be useful in a variety of other clinical situations outside of imaging. This aligns with our positive experiences performing in-clinic correction of postaxial polydactyly Type B using a combination of fast, feed and wrap (FFW) technique and local anesthetic.…”

Section: Comparison To Other Methodsmentioning

confidence: 93%

Use of a “Fast, Feed, and Wrap” Technique with Local Anesthesia for In-Office Surgical Correction of Postaxial Polydactyly Type B in Infants

Gottschalk¹,

Garza²,

McMahon³

et al. 2022

Journal of the Pediatric Orthopaedic Society of North America

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Surgical correction of postaxial polydactyly type B has several potential advantages over the traditional approach of suture ligation. Benefits include achieving more cosmetic results, reduced risk of neuroma or bothersome scar, and decreased likelihood of needing a second procedure. Previous reports with small numbers of patients have described surgical polydactyly excision using local anesthesia only, either in the operating room or office setting. We now routinely perform these removals in the office using local anesthesia combined with a fast, feed and wrap (FFW) technique to improve the comfort of the patient and parents. Details and photos of this technique are provided, and we encourage those who still perform routine suture ligation to consider this method as a simple and effective alternative.

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Section: Comparison To Other Methodsmentioning

confidence: 93%

Use of a “Fast, Feed, and Wrap” Technique with Local Anesthesia for In-Office Surgical Correction of Postaxial Polydactyly Type B in Infants

Gottschalk¹,

Garza²,

McMahon³

et al. 2022

Journal of the Pediatric Orthopaedic Society of North America

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“…The respondents agreed that the top three strategies to promote the application of neonatal US-guided ECC tip location were separately setting up a special team to organize, plan and implement the project (153, 83.6%), supplying systematic training for the people in the process (146, 80.2%), and gaining financial and institutional support from the hospital or department (145, 79.7%). Undoubtedly, the establishment of a set of targeted management systems at the hospital level would be greatly conducive to the development and continuous improvement of the project ( 13 , 14 ), and ECC-specialized management would offer accurate and timely supervision and control throughout the ECC process, ensuring that the procedures are well-regulated to better reduce the risks ( 7 , 15 ). Avoiding X-ray exposure, providing a real-time dynamic display, and the timely finding and reducing the chances of misplaced tips during catheter use rank among the top three merits of US-guided ECC tip location as recognized by the respondents.…”

Section: Discussionmentioning

confidence: 99%

“…However, according to this study, neonatal US-guided ECC tip location is seldom used in Chinese medical institutions, and there are some deficiencies presented in the project's promotion and management. Therefore, it is suggested that the administrators and nursing experts of tertiary hospitals jointly formulate a unified standardized workflow and effectiveness evaluation index system for neonatal US-guided ECC tip location ( 19 ), construct clinical practice guidelines, and promote its standardization and scientific process ( 13 , 14 ).…”

Section: Discussionmentioning

confidence: 99%

A Survey of the Practice Status Quo of Ultrasound-Guided ECC Tip Location for Neonatal Patients in 31 Provinces of China

Liu

Tao²,

Xu³

et al. 2022

Front. Pediatr.

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ObjectiveTo investigate the status quo of implementing ultrasound (US)-guided epicutaneo-caval catheters (ECC) tip location for neonatal patients in 31 provinces.MethodsThe convenience sampling method was used to investigate the nursing managers and ECC (or intravenous therapy) nurses of 91 hospitals in 31 provinces from October 29 to November 10, 2021.ResultsThe survey involved a total of 182 medical staff, including 91 managers and 91 nurses, and 91 institutions, including 22 children's hospitals, 49 general hospitals and 21 maternal and child health care hospitals. Sixteen hospitals (17.6%) carried out US-guided ECC for neonatal patients; 176 subjects (96.7%) of the 91 hospitals had known about or heard of the technology of US-guided ECC. The low awareness of operators of the tip location of ECC catheters in children under ultrasound guidance (OR = 2.690, 95% CI = 1.163–6.221), limited conditions in existing wards (OR = 2.953, 95% CI = 1.285–6.790), and insufficient funds (OR = 2.836, 95% CI = 1.149–7.004) were the independent risk factors responsible for the failure to carry out ultrasonic-guided location of ECC tips in newborns.ConclusionThe popularity of neonatal US-guided ECC location was seriously hindered by factors such as a low awareness rate of the project, the low qualification certification rate of the nursing staff, a flawed performance allocation system, and the lack of a professional team, among other factors.

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“…On 258 occasions (8.7% of catheters), patients were discharged home with a peripherally inserted central catheter for treatment continuation. Median time to catheter removal or home discharge with the line was 12 days (interquartile range [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Section: Patient Population Indications and Placementmentioning

confidence: 99%

Complications associated with peripherally inserted central catheters in paediatric cardiac patients

2022

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Objectives: To characterise the use of peripherally inserted central catheters in paediatric cardiac patients and to identify risk factors associated with their complications. Materials and Methods: Observational retrospective cohort study in paediatric cardiac patients who underwent peripherally inserted central catheter placement in a tertiary children’s hospital from January 2000 to June 2018. Results: 1822 cardiac patients underwent 2952 peripherally inserted central catheter placements in the study period. Median age was 29 days, with survival to hospital discharge of 96.4%. Successful placement achieved 94.5% of attempts, with a median line duration of 12 days. Factors associated with successful placement were the use of general anaesthesia (odds ratio 7.52, p < 0.001) and year of placement (odds ratio 1.08, p < 0.001). The incidence of complications was 28.6%, with thrombosis/occlusion being the most frequent (33%). Thrombosis/occlusion were associated with two and three lumens (odds ratio 1.96, p < 0.001 and 4.63, p = 0.037, respectively). Lines placed by interventional radiology had decreased infiltration (odds ratio 0.20, p = 0.002) and lower migration/malposition (odds ratio 0.36, p < 0.001). The use of maintenance intravenous fluids (odds ratio 3.98, p = 0.008) and peripheral tip position (odds ratio 3.82, p = 0.001) were associated with increased infiltration. The probability of infection decreased over time (odds ratio 0.79, p < 0.001). Conclusion: Peripherally inserted central catheters in paediatric cardiac patients have complication rates similar to other paediatric populations. A prospective assessment of the factors associated with their complications in this patient population may be beneficial in improving outcomes.

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Infant peripherally inserted central catheter insertion without general anesthesia

Cited by 4 publications

References 18 publications

Use of a “Fast, Feed, and Wrap” Technique with Local Anesthesia for In-Office Surgical Correction of Postaxial Polydactyly Type B in Infants

Use of a “Fast, Feed, and Wrap” Technique with Local Anesthesia for In-Office Surgical Correction of Postaxial Polydactyly Type B in Infants

A Survey of the Practice Status Quo of Ultrasound-Guided ECC Tip Location for Neonatal Patients in 31 Provinces of China

Complications associated with peripherally inserted central catheters in paediatric cardiac patients

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