1/3. Pseudoaneurysms of the brachial artery following venipuncture in infants.Pediatric vascular injuries are increasing in frequency and represent a challenging problem in pediatric surgical practice. Increased survival of low birth weight infants and advances in invasive diagnostic procedures have resulted in a dramatic increase in the number of these injuries. Formation of pseudoaneurysm of the brachial artery in infants is a very rare complication of venipuncture, with only two cases reported in the literature. We report three cases of brachial artery pseudoaneurysm in infants following venipuncture who were operated upon in our institution, aged 43-64 days at the time of operation. The period from the injury to the operation ranged from 25 to 42 days. All three infants were referred from different institutions. In two infants, the pseudoaneurysms and the involved part of the artery were resected, and arterial continuity was restored with an end-to-end anastomosis; in the other infant, reconstruction was done using a venous interposition graft. All three infants were diagnosed with duplex ultrasonography, and the child requiring a more complex reconstructive procedure was also evaluated with helical contrast computed tomography. brachial artery pseudoaneurysms are a rare but possible complication of multiple venipuncture in infants. early diagnosis and microvascular reconstruction are key points in managing these injuries.- - - - - - - - - - ranking = 1keywords = venipuncture (Clic here for more details about this article) |
2/3. False aneurysm of the brachial artery in an infant following attempted venipuncture.False aneurysms have rarely been described in the pediatric age-group. Here a case of false aneurysm of the brachial artery following accidental arterial puncture at the site of attempted venipuncture is reported. Having obtained vascular control with digital compression, the arterial repair was performed by direct suture technique. The characteristics and differential diagnosis of false aneurysms are described. The majority of false aneurysms occur as complications of percutaneous catheterization.- - - - - - - - - - ranking = 0.71428571428571keywords = venipuncture (Clic here for more details about this article) |
3/3. infection control and hiv-related discrimination and anxiety. Glove use during venipuncture.OBJECTIVE: Reports into hiv-related discrimination reveal continuing concerns about the behaviour of health care workers, particularly with reference to practices such as excessive or selective infection control. This study examines whether the selective adoption of an infection control procedure (using gloves during venipuncture) is related to discriminatory attitudes, anxiety about hiv/AIDS and the degree of contact with hiv-infected patients. METHOD: In 1993 and 1994, 451 general practitioners (GPs) were surveyed in six of the 12 new south wales health Areas and Regions. The sample included 49 anti-retroviral prescribers. GPs were presented with six patient scenarios and asked with whom they would use gloves during venipuncture. RESULTS: 41.9% of GPs reported that they would selectively use gloves, and generally targeted the homosexual patient only, or combinations of patients that included the homosexual man. GPs revealed poor compliance with universal precautions, as only 37.5% reported that they would use gloves with all of the six patients. Intended glove use was significantly related to hiv-related discrimination (p < 0.0001) and anxiety about hiv/AIDS (p < 0.0001). GPs who selectively chose to use gloves had the highest discrimination and anxiety scores; GPs who chose not to use gloves with any of the patients had the lowest discrimination and anxiety scores, and were more likely to work in hiv medicine. Except for differences in health Area, this study did not identify any factors that helped to explain which GPs consistently followed universal precautions. CONCLUSION: This study demonstrates that selective infection control is related to discriminatory attitudes and anxiety about hiv/AIDS. GPs can avoid a discriminatory practice by consistently following universal precautions. More research is needed to identify the factors that promote good infection control practices.- - - - - - - - - - ranking = 0.85714285714286keywords = venipuncture (Clic here for more details about this article) |