CVME Insider: Nursing Knowledge That Matters

Intravenous Lipids Intravenous Lipids have been used in the clinical setting for over 3 decades. However, the use of these intravenous fluids have had a widespread element of controversy. Some healthcare providers question whether we should be using intravenous lipids due to the potential compromise of patient outcomes. Over the past 15 years new lipids that include olive oil and/or fish oil have been introduced with some remarkable findings seen when these new lipids replace the more traditional ones.     The most widely available intravenous lipids are prepared from soybean oil or a combination of soybean and safflower oil. All of the emulsions are emulsified with egg yolk phospholipid, with glycerol added to achieve an isotonic solution.  The issue of  Lipid function and use in pediatric, adult surgical and critically ill patients were covered in a Swedish Symposium with the aim of developing a clearer picture of the current situation.  ...

Sepsis is a consequence of infection that is difficult to predict, diagnose, and treat. Patients who develop sepsis have an increased risk of complications and death and face higher healthcare costs and longer treatment.  CDC is working to increase sepsis awareness and improve treatment among the public, healthcare providers, and healthcare facilities.  It kills more people than HIV/Aids, prostate cancer and breast cancer combined. What is sepsis? Sepsis is an illness that affects all parts of the body that can happen in response to an infection and can quickly become life-threatening. In severe cases of sepsis, one or more organs fail. In the worst cases, sepsis causes the blood pressure to drop and the heart to weaken, leading to septic shock. Once this happens, multiple organs may quickly fail and the patient can die. Sepsis is a serious illness that is very difficult to predict, diagnose, and treat. Patients who develop sepsis have an increased risk of complic...

Does Your Hospital Use the  The Surviving Sepsis Campaign ? This c ampaign  was created to help healthcare workers implement the recommended guidelines for Severe Sepsis patients in the Emergency Room (ER) and Intensive Care Units (ICU).  The  Surviving Sepsis Campaign  kits include posters, pocket guides, bundle cards, lapel pins and a list of resources to aid your implementation efforts using the most recent edition of the international sepsis guidelines.   The Surviving Sepsis Campaign has developed pre-packaged kits to help clinicians within institutions to improve sepsis identification, management and treatment.   "The Surviving Sepsis Campaign (SSC) partnered with the Institute for Healthcare  Improvement (IHI) to incorporate its “bundle concept” into the diagnosis and treatment  of patients with severe sepsis and septic shock. We believe that improvement in  the delivery of care should be measured one patient a...

3.8 million central venous catheters (CVCs).... 2 million peripherally inserted central catheters (PICCs)..... and 310 million peripheral intravenous devices sold yearly in the US......   "Based on average salary and benefits for an RN, the average time of 36 minutes for a nurse to trouble shoot and restart a PIV translates to a labor cost of an estimated $22.79 per incident ( Rosenthal, 2005 )."   Vascular access and Infusion Therapy  is clearly a high priority and nurses take a lot of time performing these procedures for our patients. Getting the right vascular access device placed early in the hospital stay can speed treatment and patient discharge while minimizing cost as well as restarts.   Maintaining the health of our patients veins and arteries has become an important issue as patients now come to hospitals more acutely ill, living longer, often having chronic conditions. According to the Centers for Disease Control (CDC) selection of the...

  A Huber Needle is a specially designed hollow needle used with implanted ports. A Huber needle has a long, beveled tip that is inserted through the patients skin as well until it accesses the silicone septum the implanted port's reservoir. The beveled tip of a Huber needle will not remove a core of silicone from implanted port as this is the way it is designed.   This design will allow as much as 2000 needle sticks into the implanted port’s reservoir without having to be changed. Dr. Ralph L. Huber , a dentist, designed the sharp, beveled, directional needle tip and Dr. Edward B. Tuohy, an anesthesiologist, refined it for use in spinal catheters. Huber needles are used to access ports implanted under the skin of patients who may be suffering from a chronic illness, such as cancer, pancreatitis, or has the need for repeated access to veins for blood withdrawal.   These patients often need the implanted port for infusion of medication , nutritional solutions, blo...

IV Fluid Resuscitation The human body is composed of different fluid compartments and each compartment is important in regards to fluid resuscitation; however, each compartment must work in cohesion with the other. Our bodies are made up of mostly water; and water is the key source of life. However, if the water in our bodies is not distributed correctly it can have a detrimental impact on the patient’s outcome. The fluid compartments consist of the Intracellular Fluid Compartment (ICF), the Extracellular Fluid Compartment (ECF), the intravascular space, and the interstitial space. The Intracellular Fluid Compartment contains about two-thirds of the body’s total fluid or 66% according to the manual of Critical Care; whereas the Extracellular compartment consists of one-third or 33% our total fluid. The Extracellular compartment may be broken down further into the intravascular space and interstitial spaces. The intravascular space contains approximately 25% and the...