Evaluating Effectiveness of the Use of an Extremity Stabilization Device for Vascular Access Procedures in Pediatrics

Abstract

The purpose of this study is to evaluate the effectiveness of SafeBoard, a Food and Drug Administration–approved extremity stabilization device, as an assistive method in performing peripherally inserted central catheter procedures on children 0 to 3 years of age. This is a retrospective chart review (n = 59) of vascular access procedures where SafeBoard was utilized (n = 32) in comparison to those procedures which utilized a traditional approach to placement (n = 27). Statistical analysis demonstrated significant effect on length of procedure time, number of personnel needed for procedure, and success of placement when SafeBoard was utilized. Obtaining vascular access in pediatrics can be a challenging endeavor. Most young pediatric patients require procedural sedation and/or assistive personnel as a “holder” for successful vascular access placement to occur. An alternative option for extremity stabilization may provide improved workflow and improved placement success, which in turn may positively affect workflow.

Keywords

vascular access - extremity stabilization - PICC placement - pediatric

Publikationsverlauf

Eingereicht: 12. August 2021

Angenommen: 16. September 2021

Artikel online veröffentlicht:
25. Oktober 2021

• References

• 1 Takeshita J, Inata Y, Ito Y. et al. Dynamic needle tip positioning for ultrasound-guided placement of a peripherally inserted central catheter in pediatric patients. J Cardiothorac Vasc Anesth 2020; 34 (01) 114-118
• 2 Bellolio MF, Puls HA, Anderson JL. et al. Incidence of adverse events in paediatric procedural sedation in the emergency department: a systematic review and meta-analysis. BMJ Open 2016; 6 (06) e011384
• 3 Coté CJ, Wilson S. AMERICAN ACADEMY OF PEDIATRICS, AMERICAN ACADEMY OF PEDIATRIC DENTISTRY. Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures. Pediatrics 2019; 143 (06) e1-e3
• 4 Sahyoun C, Cantais A, Gervaix A, Bressan S, Löllgen R, Krauss B. Pediatric Emergency Medicine Comfort and Analgesia Research in Europe (PemCARE) group of the Research in European Pediatric Emergency Medicine. Pediatric procedural sedation and analgesia in the emergency department: surveying the current European practice. Eur J Pediatr 2021; 180 (06) 1799-1813
• 5 Rutledge D, Viele C. Insertion and care of peripherally inserted central catheters (PICCs) for intravenous infusions. Online J Clin Innov 2006; 9 (02) 1-73
• 6 Ortiz GS, OʼConnor T, Carey J. et al. Impact of a child life and music therapy procedural support intervention on parental perception of their child's distress during intravenous placement. Pediatr Emerg Care 2019; 35 (07) 498-505
• 7 Gallagher RA, Levy J, Vieira RL, Monuteaux MC, Stack AM. Ultrasound assistance for central venous catheter placement in a pediatric emergency department improves placement success rates. Acad Emerg Med 2014; 21 (09) 981-986
• 8 Spencer TR, Bardin-Spencer A. Ultrasound guidance for vascular access procedures by qualified vascular access specialists or other applicable healthcare clinicians. J Assoc Vasc Access 2019; 24 (04) 18-22
• 9 Elkhunovich M. The use of ultrasound for peripheral IV placement by vascular team nurses at a tertiary children's hospital. J Assoc Vasc Access 2015; 20 (04) 258
• 10 Haile D, Suominen PK. Technologies in pediatric vascular access: have we improved success rate in peripheral vein cannulation?. Acta Anaesthesiol Scand 2017; 61 (07) 710-713
• 11 Bienvenu A. Extremity stabilization system for medical procedures. U.S. Patent no. 10,583,274. Washington, DC: U.S. Patent and Trademark office
• 12 Liu Y, Huang X, Luo B, Peng W. Effects of combined oral sucrose and nonnutritive sucking (NNS) on procedure pain of NICU newborns, 2001 to 2016. Medicine (Baltimore) 2017; 96 (06) e6108
• 13 Intellectus Statistics [Online computer software]. (2021). Intellectus Statistics. Accessed on March 8, 2021 at: https://analyze.intellectusstatistics.com/
• 14 Cohen J. Statistical Power Analysis for the Behavior Sciences. 2nd ed.. West Publishing Company; St. Paul, MN: 1988
• 15 McGrath RE, Meyer GJ. When effect sizes disagree: the case of r and d. Psychol Methods 2006; 11 (04) 386-401
• 16 Rice ME, Harris GT. Comparing effect sizes in follow-up studies: ROC area, Cohen's d, and r. Law Hum Behav 2005; 29 (05) 615-620
• 17 Johnson D, Snyder T, Strader D, Zamora A. Positive influence of a dedicated vascular access team in an acute care hospital. J Assoc Vasc Access 2017; 22 (01) 35-37
• 18 Taylor T, Massaro A, Williams L. et al. Effect of a dedicated percutaneously inserted central catheter team on neonatal catheter-related bloodstream infection. Adv Neonatal Care 2011; 11 (02) 122-128
• 19 de Carvalho Onofre PS, da Luz Gonçalves Pedreira M, Peterlini MA. Placement of peripherally inserted central catheters in children guided by ultrasound: a prospective randomized, and controlled trial. Pediatr Crit Care Med 2012; 13 (05) e282-e287
• 20 Li J, Fan YY, Xin MZ. et al. A randomised, controlled trial comparing the long-term effects of peripherally inserted central catheter placement in chemotherapy patients using B-mode ultrasound with modified Seldinger technique versus blind puncture. Eur J Oncol Nurs 2014; 18 (01) 94-103
• 21 Paterson RS, Chopra V, Brown E. et al. Selection and insertion of vascular access devices in pediatrics: a systematic review. Pediatrics 2020; 145 (Suppl. 03) S243-S268
• 22 Westergaard B, Classen V, Walther-Larsen S. Peripherally inserted central catheters in infants and children - indications, techniques, complications and clinical recommendations. Acta Anaesthesiol Scand 2013; 57 (03) 278-287