Critical Appraisal Guidelines Part 2

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Critical Appraisal Guidelines: Qualitative - Part 2
Amanda T. Creel
Grand Canyon University: NRS – 433V
June 9, 2013

The research article reviewed was “Ultrasound – Guided Peripheral Venous Access vs. the External Jugular Vein as the Initial Approach to the Patient with Difficult Vascular Access” by T.G. Costantino MD, J. F. Kirtz MD, and W. A. Satz MD. Intravenous (IV) access is commonly performed in the Emergency Department (ED). In patients with difficult access, physicians are frequently called upon to perform these procedures. Physicians should be familiar with both the external jugular (EJ) IV technique and the ultrasound – guided IV (USIV) peripheral access techniques. Some hospitals have specialized team of nurses that have been educated and trained on the proper way to establish an EJ IV and/or USIV. This study examined both techniques and collected data to establish which techniques was better for the patient.
Protection of Human Participants
Risks and Benefits Addressed by the Authors The benefit of this study was to spare the ED patient with difficult veins from having to receive a central venous line. The infection rate is higher in a central line than a peripheral IV line. The use of USIV will also decrease the number or IV attempts instead of a central line. While this decreased the actual number of IV attempts, it still had some risks. One major risk is arterial punctures. The other risks include nerve irritation and hematomas at the site of both USIV and EJ IV attempts.
Consents and Approvals The study was approved by the university’s institutional review board of an urban, tertiary – care university hospital ED. The subjects entered the study voluntarily after being education on the research. After the education process, a written consent was obtained. The patient was then placed in a randomized tract of the study.
Data Collection…...

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