Pub Date : 2022-12-02DOI: 10.5005/jp-journals-11010-06106
T. Sushma
Patients require admission to intensive care unit with endotracheal intubation and mechanical ventilation for various reasons. It can last for a short duration or could be prolonged. The endotracheal tube is removed once the underlying problem is resolved and is called planned extubation. Sometimes extubation occurs unintentionally and is called unplanned extuabtion. Unplanned extubation could be accidental or self extubation. There is a potential risk of unplanned extubation as long as the patient remains intubated. As unplanned extubation can lead to catastrophic events, it is ideal to have a weaning protocol in place so that the patients are extubated as soon as they satisfy the extubation criteria. This CME article mainly focuses on the risk factors for unplanned extubation in the adult intensive care unit and the complications associated with it. The strategies for prevention of unplanned extubation has been highlighted at the end.
{"title":"Unplanned extubations in the adult intensive care units","authors":"T. Sushma","doi":"10.5005/jp-journals-11010-06106","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-06106","url":null,"abstract":"Patients require admission to intensive care unit with endotracheal intubation and mechanical ventilation for various reasons. It can last for a short duration or could be prolonged. The endotracheal tube is removed once the underlying problem is resolved and is called planned extubation. Sometimes extubation occurs unintentionally and is called unplanned extuabtion. Unplanned extubation could be accidental or self extubation. There is a potential risk of unplanned extubation as long as the patient remains intubated. As unplanned extubation can lead to catastrophic events, it is ideal to have a weaning protocol in place so that the patients are extubated as soon as they satisfy the extubation criteria. This CME article mainly focuses on the risk factors for unplanned extubation in the adult intensive care unit and the complications associated with it. The strategies for prevention of unplanned extubation has been highlighted at the end.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48168548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-02DOI: 10.5005/jp-journals-11010-04112
Shaji Mathew, Souvik Chaudhuri, A. Kumar, R. Krishna, K. Goyal
A 56 year old female patient belonging to American Society of Anaesthesiologists Physical Status (ASA-PS) 1 underwent emergency laparoscopic appendectomy. Surgery was uneventful. After reversal of the neuromuscular blockade and extubation, patient sustained acute upper airway obstruction due to laryngospasm and developed negative pressure pulmonary oedema, which resolved after a period of about 15 hours of mechanical ventilation.
{"title":"Negative Pressure Pulmonary Oedema – Lessons learnt","authors":"Shaji Mathew, Souvik Chaudhuri, A. Kumar, R. Krishna, K. Goyal","doi":"10.5005/jp-journals-11010-04112","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-04112","url":null,"abstract":"A 56 year old female patient belonging to American Society of Anaesthesiologists Physical Status (ASA-PS) 1 underwent emergency laparoscopic appendectomy. Surgery was uneventful. After reversal of the neuromuscular blockade and extubation, patient sustained acute upper airway obstruction due to laryngospasm and developed negative pressure pulmonary oedema, which resolved after a period of about 15 hours of mechanical ventilation.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47303122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-02DOI: 10.5005/jp-journals-11010-04210
Souvik Chaudhuri
Patients with complex medical and surgical issues are often admitted to the intensive care unit (ICU). In such patients, prompt administration of broad spectrum empirical antibiotics is mandatory to control the infection. Antibiotic therapy should be instituted as soon as possible after the relevant culture specimens of blood, urine, endotracheal secretions or cerebrospinal fluid are sent. Ideally, empirical antibiotic therapy should be initiated within the first hour of admission of patients with suspected sepsis in ICU. While selecting the empirical antibiotic therapy, the patient's clinical history along with the probable source of infection, previous antibiotic history and most likely pathogens according to the prevalence in the particular intensive care unit (ICU) should be taken into account. A delay in initiating empirical antibiotic therapy is associated with a higher risk of progression to severe sepsis, more days on ventilator and ultimately an adverse outcome. However, empirical therapy should be de-escalated as soon as the culture and sensitivity reports are available to the clinician.
{"title":"Empirical antibiotics in the intensive care unit","authors":"Souvik Chaudhuri","doi":"10.5005/jp-journals-11010-04210","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-04210","url":null,"abstract":"Patients with complex medical and surgical issues are often admitted to the intensive care unit (ICU). In such patients, prompt administration of broad spectrum empirical antibiotics is mandatory to control the infection. Antibiotic therapy should be instituted as soon as possible after the relevant culture specimens of blood, urine, endotracheal secretions or cerebrospinal fluid are sent. Ideally, empirical antibiotic therapy should be initiated within the first hour of admission of patients with suspected sepsis in ICU. While selecting the empirical antibiotic therapy, the patient's clinical history along with the probable source of infection, previous antibiotic history and most likely pathogens according to the prevalence in the particular intensive care unit (ICU) should be taken into account. A delay in initiating empirical antibiotic therapy is associated with a higher risk of progression to severe sepsis, more days on ventilator and ultimately an adverse outcome. However, empirical therapy should be de-escalated as soon as the culture and sensitivity reports are available to the clinician.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49418591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-02DOI: 10.5005/jp-journals-11010-05108
Rajendra Prasad Tarigopula, H. Mahto, N. Mathew
Introduction: Chronic obstructive pulmonary disease (COPD) is associated with intermittent exacerbation with deterioration in their symptoms of dyspnoea and cough with expectoration. These patients often require repeated hospitalisation for the control of these exacerbations. Repeated hospitalisation can have persistent psychological effects on these patients. Methodology: This was a prospective, observational study. Twenty nine patients admitted to the medical intensive care unit (ICU) with a diagnosis of COPD were enrolled. They were assessed for anxiety and depression using hospital anxiety and depression scale (HADS). Hospital anxiety and depression questionnaire were addressed to patient twice: once just before discharge from ICU and again just before discharge from ward and the results were compared. Result: Out of twenty nine patients, 8 (27.5%) showed anxiety, 6 (20.6%) patients were having borderline anxiety and 15 (51.7%) patients had no anxiety. Ten (35%) patients showed depression, 13 (45%) patients had borderline depression and 6 (20%) patients had no depression during intensive care management. In the ward, the same patients were assessed again for anxiety. Five (17.2%) patients showed anxiety, 10 (34.8%) patients had borderline anxiety and 14 (48.2%) patients had no anxiety during ward stay. Similarly, four (13.7%) patients showed depression, 13 (44.8%) patients had borderline depression and 12 (41.3%) patients had no depression. Conclusion: Anxiety and depression is common in COPD patients and it is more during ICU stay compared to ward stay.
{"title":"Assessment of hospital anxiety and depression in adult patients with chronic obstructive pulmonary disease: an observational study","authors":"Rajendra Prasad Tarigopula, H. Mahto, N. Mathew","doi":"10.5005/jp-journals-11010-05108","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-05108","url":null,"abstract":"Introduction: Chronic obstructive pulmonary disease (COPD) is associated with intermittent exacerbation with deterioration in their symptoms of dyspnoea and cough with expectoration. These patients often require repeated hospitalisation for the control of these exacerbations. Repeated hospitalisation can have persistent psychological effects on these patients. Methodology: This was a prospective, observational study. Twenty nine patients admitted to the medical intensive care unit (ICU) with a diagnosis of COPD were enrolled. They were assessed for anxiety and depression using hospital anxiety and depression scale (HADS). Hospital anxiety and depression questionnaire were addressed to patient twice: once just before discharge from ICU and again just before discharge from ward and the results were compared. Result: Out of twenty nine patients, 8 (27.5%) showed anxiety, 6 (20.6%) patients were having borderline anxiety and 15 (51.7%) patients had no anxiety. Ten (35%) patients showed depression, 13 (45%) patients had borderline depression and 6 (20%) patients had no depression during intensive care management. In the ward, the same patients were assessed again for anxiety. Five (17.2%) patients showed anxiety, 10 (34.8%) patients had borderline anxiety and 14 (48.2%) patients had no anxiety during ward stay. Similarly, four (13.7%) patients showed depression, 13 (44.8%) patients had borderline depression and 12 (41.3%) patients had no depression. Conclusion: Anxiety and depression is common in COPD patients and it is more during ICU stay compared to ward stay.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48462675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-02DOI: 10.5005/jp-journals-11010-04209
A. Shenoy
Trauma constitutes a large proportion of the number of lives lost, especially in the productive age group. Trauma-related deaths have a trimodal distribution: First, at site or on transfer due to severity of trauma injuries. The injury could be so severe that nothing can be done to save the life of that trauma victim. Second phase of deaths is usually due to hypovolaemia and are often treatable and avoidable. Timely and appropriate intervention at this stage can reduce the effects of trauma and prevent morbidity secondary to the injury. The third phase includes those patients who die of complications of trauma such as infection, embolism, sepsis, ARDS and septic shock. A well-managed second phase is likely to reduce the incidence of the third phase. A systematic approach to a victim of trauma is very necessary so that any life-threatening injury is not missed. The approach to trauma must be done in the following steps: Primary survey and resuscitation, secondary survey and definitive care. This article outlines the various steps of the initial management of trauma.
{"title":"Initial management of trauma victims","authors":"A. Shenoy","doi":"10.5005/jp-journals-11010-04209","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-04209","url":null,"abstract":"Trauma constitutes a large proportion of the number of lives lost, especially in the productive age group. Trauma-related deaths have a trimodal distribution: First, at site or on transfer due to severity of trauma injuries. The injury could be so severe that nothing can be done to save the life of that trauma victim. Second phase of deaths is usually due to hypovolaemia and are often treatable and avoidable. Timely and appropriate intervention at this stage can reduce the effects of trauma and prevent morbidity secondary to the injury. The third phase includes those patients who die of complications of trauma such as infection, embolism, sepsis, ARDS and septic shock. A well-managed second phase is likely to reduce the incidence of the third phase. A systematic approach to a victim of trauma is very necessary so that any life-threatening injury is not missed. The approach to trauma must be done in the following steps: Primary survey and resuscitation, secondary survey and definitive care. This article outlines the various steps of the initial management of trauma.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44336373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-02DOI: 10.5005/jp-journals-11010-05104
H. Mahto, N. Somanathan, B. Deepak
Introduction: Arterial blood gas (ABG) testing requires puncture of an artery to obtain a blood sample for analysis. It is a common procedure in the hospital to allow assessment of pulmonary gas exchange. Compared with vein puncture, arterial puncture is more difficult, requires deeper needle insertion and is more painful for the patient. Cryoanalgesia would offer a noninvasive, nonpharmacologic, inexpensive and readily available tool to reduce pain associated with arterial puncture. This study sought to determine whether cryoanalgesia in the form of ice application could be an effective analgesic when applied before arterial puncture. Methodology: This was a prospective study with a convenience sample of intensive care unit patients on oxygen therapy with a physician order for an ABG test. The intervention group had a plastic bag of ice applied to their wrists for 3 min before drawing an ABG sample from the radial artery. The control group had an ABG sample drawn from the radial artery without the application of ice. Pain from the arterial puncture was measured with a pain rating scale. Results: Subjects pretreated with ice reported less pain from arterial puncture compared with subjects in the control group (median pain rating scale 2.00 Inter Quartile Range (IQR) 2.00-1.00 Vs 4.00 IQR 5.00-3.25, P = 0.01). Conclusions: Use of cryoanalgesia (Ice bag) reduces the pain associated with arterial puncture.
简介:动脉血气(ABG)测试需要穿刺动脉获得血液样本进行分析。这是一个常见的程序，在医院允许评估肺气体交换。与静脉穿刺相比，动脉穿刺难度更大，需要更深的针头插入，对患者来说更痛苦。低温镇痛将提供一种无创、非药物、廉价和容易获得的工具来减少动脉穿刺相关的疼痛。本研究旨在确定冰敷形式的低温镇痛在动脉穿刺前是否有效。方法学:这是一项前瞻性研究，以重症监护病房患者为样本，在医生的指示下进行ABG测试。干预组在从桡动脉提取ABG样本之前，将一个装有冰块的塑料袋敷在手腕上3分钟。对照组在未冰敷的情况下从桡动脉抽取ABG样本。用疼痛评定量表测量动脉穿刺引起的疼痛。结果:与对照组相比，经冰敷预处理的受试者动脉穿刺疼痛减轻(疼痛评定量表中位数2.00四分位间距(IQR) 2.00-1.00 Vs 4.00 IQR 5.00-3.25, P = 0.01)。结论:冷敷(冰袋)可减轻动脉穿刺引起的疼痛。
{"title":"Effect of using different sizes of needle along with cryoanalgesia on pain associated with arterial blood gas sampling: A prospective study","authors":"H. Mahto, N. Somanathan, B. Deepak","doi":"10.5005/jp-journals-11010-05104","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-05104","url":null,"abstract":"Introduction: Arterial blood gas (ABG) testing requires puncture of an artery to obtain a blood sample for analysis. It is a common procedure in the hospital to allow assessment of pulmonary gas exchange. Compared with vein puncture, arterial puncture is more difficult, requires deeper needle insertion and is more painful for the patient. Cryoanalgesia would offer a noninvasive, nonpharmacologic, inexpensive and readily available tool to reduce pain associated with arterial puncture. This study sought to determine whether cryoanalgesia in the form of ice application could be an effective analgesic when applied before arterial puncture. Methodology: This was a prospective study with a convenience sample of intensive care unit patients on oxygen therapy with a physician order for an ABG test. The intervention group had a plastic bag of ice applied to their wrists for 3 min before drawing an ABG sample from the radial artery. The control group had an ABG sample drawn from the radial artery without the application of ice. Pain from the arterial puncture was measured with a pain rating scale. Results: Subjects pretreated with ice reported less pain from arterial puncture compared with subjects in the control group (median pain rating scale 2.00 Inter Quartile Range (IQR) 2.00-1.00 Vs 4.00 IQR 5.00-3.25, P = 0.01). Conclusions: Use of cryoanalgesia (Ice bag) reduces the pain associated with arterial puncture.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44907537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-02DOI: 10.5005/jp-journals-11010-04101
V. Acharya, S. Vidyasagar
{"title":"Ebola virus disease - An update","authors":"V. Acharya, S. Vidyasagar","doi":"10.5005/jp-journals-11010-04101","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-04101","url":null,"abstract":"","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49110424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-02DOI: 10.5958/2320-8651.2017.00014.X
R. YUVARAJ, D. Manivannan, K. Balasubramanian, K. Muthusamy, M. Sivakumar
Introduction: There are limited Indian studies that evaluate the nurses’ knowledge of VAP prevention bundle. Aim: Our study aimed to assess the effectiveness of a structured teaching programme on VAP bundle among staff nurses in critical care unit. Methodology: The prospective, quasi-experimental study was conducted among critical care nurses. The final sample (n=57) nurses was selected by purposive sampling technique on the basis of set inclusion criteria. The nurses were first assessed for their knowledge of guidelines to prevent VAP. They were then educated using a standard teaching module and the assessment performed again. Results: There was a statistically significant increase in the knowledge level of participants by a mean (±S.D) 5.68 (±2.8) score with 95% C.I (4.94 – 6.43) and p <0.001. Conclusion: The 2-hour teaching module significantly enhanced nurses’ knowledge towards evidence based guidelines for the prevention of VAP.
{"title":"The impact of teaching on nurses’ knowledge to VAP prevention bundle","authors":"R. YUVARAJ, D. Manivannan, K. Balasubramanian, K. Muthusamy, M. Sivakumar","doi":"10.5958/2320-8651.2017.00014.X","DOIUrl":"https://doi.org/10.5958/2320-8651.2017.00014.X","url":null,"abstract":"Introduction: There are limited Indian studies that evaluate the nurses’ knowledge of VAP prevention bundle. Aim: Our study aimed to assess the effectiveness of a structured teaching programme on VAP bundle among staff nurses in critical care unit. Methodology: The prospective, quasi-experimental study was conducted among critical care nurses. The final sample (n=57) nurses was selected by purposive sampling technique on the basis of set inclusion criteria. The nurses were first assessed for their knowledge of guidelines to prevent VAP. They were then educated using a standard teaching module and the assessment performed again. Results: There was a statistically significant increase in the knowledge level of participants by a mean (±S.D) 5.68 (±2.8) score with 95% C.I (4.94 – 6.43) and p <0.001. Conclusion: The 2-hour teaching module significantly enhanced nurses’ knowledge towards evidence based guidelines for the prevention of VAP.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41856106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-02DOI: 10.5005/jp-journals-11010-04205
A. Babu
Trial registration has become an important part of clinical trials and various databases exist across the world. In India, the Clinical Trial Registry India (CTRI) was established in 2007 to promote registration of clinical trials in the country. This initiative which was part of a move to promote transparency in clinical trials has now become a requirement for publication of clinical trials across most journals. This article discusses the importance of clinical trial registration and describes the steps required to complete the registration of a clinical trial in the CTRI database.
{"title":"Clinical Trial Registration: What do we need to know?","authors":"A. Babu","doi":"10.5005/jp-journals-11010-04205","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-04205","url":null,"abstract":"Trial registration has become an important part of clinical trials and various databases exist across the world. In India, the Clinical Trial Registry India (CTRI) was established in 2007 to promote registration of clinical trials in the country. This initiative which was part of a move to promote transparency in clinical trials has now become a requirement for publication of clinical trials across most journals. This article discusses the importance of clinical trial registration and describes the steps required to complete the registration of a clinical trial in the CTRI database.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44812280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-02DOI: 10.5005/jp-journals-11010-04106
K. Afthab, H. Mahto, S. Johnson, R. Unnikrishnan
Introduction: An arterial blood gas (ABG) is a blood test that is performed using blood from an artery. When obtaining an arterial blood sample via percutaneous puncture, there is a risk of accidentally obtaining venous blood. Conventional methods of confirming arterial blood at the bedside such as blood colour and pulsatile return can be misleading in patients with low blood pressure or hypoxaemia. The blood of patients with hypoxaemia can show a dark colour similar to venous blood and patients with low blood pressure may have very low pulsatile action. Aim: The purpose of this study was to determine if the arterial sampler filling time can be an accurate predictor of obtaining arterial blood sample in adults. Methodology: Forty patients were enrolled prospectively who required arterial blood sample or venous sample in medical and surgical intensive care unit. During the arterial and venous puncture procedures the amount of time it took to fill the sample tube was measured with the help of stop watch in s/ml was measured. Results: Twenty patients were in the arterial group and 20 patients in venous group. The mean ± SD filling time was 12 ± 3 s/ml for the arterial group and 112±21 s/ml for the venous group. Conclusion: There is a statistically significant difference between arterial and venous filling times using an arterial blood sampler in human subjects. There is no relationship between mean arterial pressure (MAP) and arterial sampler filling times.
{"title":"Sampler filling time during arterial and venous puncture: An observational study","authors":"K. Afthab, H. Mahto, S. Johnson, R. Unnikrishnan","doi":"10.5005/jp-journals-11010-04106","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-04106","url":null,"abstract":"Introduction: An arterial blood gas (ABG) is a blood test that is performed using blood from an artery. When obtaining an arterial blood sample via percutaneous puncture, there is a risk of accidentally obtaining venous blood. Conventional methods of confirming arterial blood at the bedside such as blood colour and pulsatile return can be misleading in patients with low blood pressure or hypoxaemia. The blood of patients with hypoxaemia can show a dark colour similar to venous blood and patients with low blood pressure may have very low pulsatile action. Aim: The purpose of this study was to determine if the arterial sampler filling time can be an accurate predictor of obtaining arterial blood sample in adults. Methodology: Forty patients were enrolled prospectively who required arterial blood sample or venous sample in medical and surgical intensive care unit. During the arterial and venous puncture procedures the amount of time it took to fill the sample tube was measured with the help of stop watch in s/ml was measured. Results: Twenty patients were in the arterial group and 20 patients in venous group. The mean ± SD filling time was 12 ± 3 s/ml for the arterial group and 112±21 s/ml for the venous group. Conclusion: There is a statistically significant difference between arterial and venous filling times using an arterial blood sampler in human subjects. There is no relationship between mean arterial pressure (MAP) and arterial sampler filling times.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43719754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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