Power Hour Breakout
Tricia Kleidon, RN, BSc(Nursing), GradCert.(Pediatrics), MNursSci(NursePrac)
Nurse Practitioner and Research Fellow
Queensland Children's Hospital
3M () : Speaker's Bureau; Angiodynamics () : Grant/Research Support, Speaker's Bureau; Baxter Healthcare () : Grant/Research Support, Other Financial or Material Support, support with in kind supply of product; Carefusion/BD Medical () : Speaker's Bureau; Centurion Medical Products () : Grant/Research Support; COOK Medical () : Speaker's Bureau; CR Bard Medical () : Consultant, Other Financial or Material Support, support workshop with use of equipment; MSA () : Speaker's Bureau; Vygon: Speaker's Bureau (Status: Terminated --- 1//2019)
Stephanie Pitts, MSN, RN, CPN, VA-BC™
Director, Healthcare Strategy & Innovation
B.Braun & St. Joseph's Children's Hospital
AngioDynamics, Inc.: Other Financial or Material Support (Status: Ongoing), Previous employee, stockholder (Status: Ongoing); B.Braun: Full-time employee (Status: Ongoing), Other Financial or Material Support (Status: Ongoing); St. Joseph's Children's Hospital of Tampa: Other Financial or Material Support (Status: Ongoing), Staff Nurse (Status: Ongoing)
Midlines are medium term vascular access devices (VADs). Reported benefits of midlines, in comparison to peripheral intravenous catheters (PIVCs) include extended function and fewer overall needle stick punctures. In comparison to PICCs they have reportedly fewer complications such as infection and thrombosis and are potentially a simple, low-cost, GA free insertion in some age groups. Midlines are not completely innocuous and used inappropriately can cause patient harm and compromise the patients long term vessel health and preservation. To date, no robust clinical trial data exists comparing the benefits and adverse effects of midlines in children. Adult clinical trial data reports midlines can be used safely and are a low cost alternative to PICCs in adults requiring pulmonary optimisation.
Pulmonary optimisation for children with respiratory disease such as cystic fibrosis is important to promote health, and reduce hospitalisation. The scheduled administration of intravenous antibiotics is integral to this therapy. Traditionally, peripherally inserted central catheters (PICCs) have been inserted to provide intravenous access. However, recent literature suggests up to 25% of PICCs in paediatrics are associated with significant complications including thrombosis, occlusion and infection. Often, children under the age of 10 years require a general anaesthetic to ensure procedural compliance to insert PICC. The primary outcomes of this pilot RCT is
(i) to determine the feasibility of a full efficacy RCT comparing PICCs and midlines and (ii) to reduce the need for general anaesthesia, while reliably delivering intravenous antibiotics. Secondary outcomes include; device failure and complication, delays to initiation of treatment, time to insert, cost analysis, additional device and patient, parent and clinician experience.