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Objectives: Successful placement of a peripheral intravenous catheter (PIVC) on the first attempt is an important outcome for difficult vascular access (DVA) patients. This study compared standard technique, ultrasonography (USG), and near-infrared light (NIR) in terms of success in the first attempt in patients with DVA. Methods: This was a prospective, randomized controlled study. The study was conducted in a tertiary care hospital. Emergency department patients who describe DVA history, have no visible or palpable veins, and were assessed by the nurse to have a difficult PIVC were included to study. The PIVC procedure was performed on patients by standard, USG, or NIR device techniques. For all approaches, the success of the first attempt was the primary aim. Total procedure time, the total number of attempts, and the need for rescue intervention were secondary aims. Results: This study evaluated 270 patients. The first attempt success rates for USG, standard, and NIR methods were 78.9%, 62.2%, and 58.9%, respectively. The rate of first attempt success was higher in patients who underwent USG (USG versus standard, P =.014; USG versus NIR, P =.004; standard versus NIR, P =.648). The total median (IQR) procedure time for USG, standard, and NIR methods was 107 (69-228), 72 (47-134), and 82 (61-163) seconds, respectively. The total procedure time was longer in patients undergoing USG (standard versus USG, P <.001; NIR versus USG, P =.035; standard versus NIR, P =.055). The total median (IQR) number of attempts of USG, standard, and NIR methods were 1 (1-1), 1 (1-2), and 1 (1-2), respectively. A difference was found among the groups regarding the total number of attempts (USG versus NIR, P =.015; USG versus standard P =.108; standard versus NIR, P =.307). No difference was found among groups in terms of the need for rescue methods. Conclusion: It was found that USG increases the success of the first attempt compared with the standard method and NIR in patients with DVA. [ABSTRACT FROM AUTHOR]

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To determine the factors affecting the first‐attempt success of peripheral intravenous catheter (PIVC) placement in older emergency department patients. Background: In older patients who require intravenous treatment, establishing a PIVC as fast as possible is clinically important. Design: This is a prospective, observational, descriptive study. Methods: Using a data collection form, researchers questioned both the patient and the nurse performing the procedure in terms of patient‐ and operator‐related factors. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines (See Supporting Information Appendix S1). Results: A total of 472 patients were included in the final analyses. According to the logistic regression analysis, independent factors which affected first‐attempt failure were found to be: choosing a nonupper extremity site for PIVC (OR: 4.72, 95% CI: 1.35–16.45, p‐value: 0.015), history of difficult intravenous access (OR: 3.02, 95% CI: 1.72–5.29, p‐value: <0.001), nurse having less than 2 years of professional experience (OR: 3.45, 95% CI: 2.00–5.97, p‐value: <0.001), nonpalpable veins observed after the application of tourniquet (OR: 2.21, 95% CI: 1.10–4.41, p‐value: 0.025), a moderate degree of difficulty anticipated by the nurse prior to the procedure (OR: 4.32, 95% CI: 2.31–8.08, p‐value: <0.001) and a high degree of difficulty anticipated by the nurse prior to the procedure (OR: 8.41, 95% CI: 4.10–17.24, p‐value: <0.001). Conclusion: Factors affecting first‐attempt success rates in peripheral intravenous catheter placement in older emergency department patients may be listed as follows: the anticipated difficulty of the procedure rated by the nurse, previous history of a difficult intravenous cannulation, choosing a nonupper extremity site for cannulation, the level of experience of the nurse and the palpability of the vein. Relevance to clinical practice: Healthcare providers should consider alternative methods in the presence of factors affecting first‐attempt success in older emergency department patients. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Trauma-related injuries constitute an important part of emergency department admissions. In order to provide appropriate health services to these patients, the readiness of physicians, especially those with limited clinical experience, should be increased in terms of knowledge and skills. In this study, it was aimed to evaluate an asynchronous e-learning module, which was prepared in order to increase the knowledge and skill levels of physicians who do not have sufficient experience in the evaluation of trauma patients, before starting to serve patients in a supervised manner, with student feedback. Methods: This research is a retrospective study in which the course feedback data of 28 students out of 39 students studying in the Emergency Medicine Specialization Training program, to whom the e-learning module on trauma was applied, were analyzed descriptively. The students' opinions were collected through an electronic questionnaire consisting of 18 likert-type and 2 open-ended questions. Results: The findings of the study showed that the asynchronous e-learning module on trauma was found to be effective in providing a flexible and accessible learning environment for students. The students found the content of the module easy to understand and evaluated it as a positive feature that they could access the content repeatedly. Conclusion: Asynchronous e-learning is a flexible, learner-centered and effective method adopted by learners for teaching theoretical content in emergency medicine residency education, while also providing more time for practical training in clinical settings for trainers and learners. [ABSTRACT FROM AUTHOR]