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A survey of invasive catheter practices in u.s. Burn centers.
MedLine Citation:
PMID:  23147213     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Burn-specific guidelines for optimal catheter rotation, catheter type, insertion methods, and catheter site care do not exist, and practices vary widely from one burn unit to another. The purpose of this study was to define current practices and identify areas of practice variation for future clinical investigation. An online survey was sent to the directors of 123 U.S. burn centers. The survey consisted of 23 questions related to specific practices in placement and maintenance of central venous catheters (CVCs), arterial catheters, and peripherally inserted central catheters (PICCs). The overall response rate was 36%; response rate from verified centers was 52%. Geographic representation was wide. CVC and arterial catheter replacement varied from every 3 days (24% of sites) to only for overt infection (24% of sites); 23% of sites did not use the femoral position for CVC placement. Nearly 60% of units used some kind of antiseptic catheter. Physicians inserted the majority of catheters, and 22% of sites used nonphysicians for at least some insertions. Ultrasound was routinely used by less than 50% of units. A wide variety of post-insertion dressing protocols were followed. PICCs were used in some critically injured patients in 37% of units; the majority of these users did not rotate PICCs. Thus, it can be surmised that wide practice variation exists among burn centers with regard to insertion and maintenance of invasive catheters. Areas with particular variability that would be appropriate targets of clinical investigation are line rotation protocols, catheter site care protocols, and use of PICCs in acute burns.
Authors:
Robert L Sheridan; Alice N Neely; Mayra A Castillo; Heather A Shankowsky; Shawn P Fagan; Kevin K Chung; Joan M Weber
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of burn care & research : official publication of the American Burn Association     Volume:  33     ISSN:  1559-0488     ISO Abbreviation:  J Burn Care Res     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101262774     Medline TA:  J Burn Care Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  741-6     Citation Subset:  IM    
Affiliation:
From the *Shriners Hospitals for Children ®-Boston, Massachusetts †Shriners Hospitals for Children ®-Cincinnati, Ohio ‡US Army Institute of Surgical Research, Fort Sam Houston, Texas §Firefighters Burn Treatment Unit, University of Alberta Hospital, Edmonton, Canada; and ║Massachusetts General Hospital, Boston.
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