Acceso venoso subcutáneo implantable. Manejo / Subcutaneous venous access implants. Handling

En esta segunda parte del artículo sobre accesos venosos subcutáneos implantables se aborda en profundidad el tema de su manejo. Nomenclatura, indicaciones, complicaciones, colocación del dispositivo y cuidados de enfermería son los grandes epígrafes de que consta. En el apartado de cuidados de enfermería se desarrollan los cuidados y mantenimiento, las normas generales, qué hacer ante una resistencia inusual de la inyección, el tratamiento fibrinolítico y el sistema intraespinal (AU)

Acceso venoso subcutáneo implantable. 1. Razones que justifican su uso / Subcutaneous venous access implants. Reasons which justify their use

El tratamiento con quimioterapia o la administración de nutrición parenteral exige la permanencia de accesos venosos durante semanas, meses o tal vez años. Disponer de un acceso venoso adecuado en el tratamiento de los enfermos graves es fundamental para garantizar la perfusión de fluidos, transfusión de sangre, administración de medicamentos, aporte de nutrientes, obtención de muestras sanguíneas... En este artículo, que continuará con una segunda parte en la que se hablará de manejo, se exponen las razones por las que se utilizan los accesos venosos subcutáneos implantables y también de cómo tratar una de sus principales complicaciones: la extravasación. La bibliografía vendrá reseñada en la segunda parte del artículo (AU)

[Implantable subcutaneous venous access. Management]. / Acceso venoso subcutáneo implantable. Manejo.

In this second article on subcutaneous venous access implants, the authors make an in depth presentation on how to handle these devices. The main topics which are covered include: nomenclature, indications, complications, how to set or implant this device and nursing treatment. Under the nursing treatment section, the authors explain care and maintenance, general regulations, what procedure to follow if one confronts an unusual resistance during an injection, fibrinolithic treatment, and the intraspinal system.

[Implantable subcutaneous venous access. 1. Reasons that justify its use]. / Acceso venosa subcutáneo implantable. 1. Razones que justifican su uso.

Chemotherapy treatment or the administering parenteral feeding requires permanent venous access during weeks, months or perhaps years. To have available an adequate venous access while treating gravely ill patients is fundamental in order to guarantee the perfusion of fluids blood transfusions administration of medicines, to supply intravenous feeding, to draw blood samples, etc. In this article, which will have a follow-up which concentrates on proper handling, the authors expose the reasons why subcutaneous venous access implants and used as well as how to deal with one of their main complications; extravasation. A bibliography will accompany the follow-up article.

[Home oxygen therapy: nursing care]. / Oxigenoterapia domiciliaria: cuidados de enfermería.

The authors present a brief historical summary of the use of oxygen therapy in a patient's home from its start in 1970 to the present time, analyzing the controversies which have developed and the interest in oxygen therapy in a patient's home. For a review of the indications, initial evaluation, requirements and dose of this treatment, one should consult the article written by these authors published in Revista Rol de Enfermeria 2000; 23(4):257-261. In continuation, the authors explain the main nursing care which a patient receiving oxygen therapy at home requires, the circumstances which can compromise its efficiency, its secondary effects and complications, and the follow-up that is necessary to carry out on patients using this therapy.

[Indications and administration: home oxygen therapy]. / Indicaciones y administración. Oxigenoterapia domiciliaria.

At the present time, it has been clearly demonstrated that at home oxygen therapy either on a long term basis or on a continuous basis brings important benefits for a patient: his/her physical and neuro-psychological conditions improve and his/her quality of life increases. However, given that this is some controversy about its indications, therapeutic effects and manner to administrate it, the authors review all these aspects, drawing from very up-to-date bibliographical references. At a later date, in another article, these same authors will evaluate nursing treatment corresponding directly to at home oxygen therapy.

Oxigenoterapia domiciliaria. Cuidados de Enfermería / Oxygen therapy in a patient's home: nursing care

Se efectúa un breve repaso histórico de la situación de la oxigenoterapia domiciliaria desde sus comienzos (en 1970) hasta la actualidad, analizando las controversias establecidas y el interés de la OD. Para un repaso de Indicaciones, Evaluación inicial, Requisitos y Dosificación es conveniente revisar el artículo de estos mismos autores publicado en Rev ROL Enf 2000; 23(4):257-261. Posteriormente se explican los principales cuidados de enfermería que requiere el paciente con oxigenoterapia domicilia- ria, las situaciones que pueden comprometer su eficacia, sus efectos secundarios y complicaciones; y el seguimiento que es preciso efectuar al paciente que la utiliza (AU)

Oxigenoterapia domiciliaria / At home oxygen therapy: indication and administration

Actualmente está plenamente demostrado que la oxigenoterapia domiciliaria a largo plazo o de forma continua supone importantes beneficios para el paciente: mejora sus condiciones físicas y neuropsicológicas, y aumenta su calidad de vida. No obstante, puesto que existe polémica con respecto a sus indicaciones, efectos terapéuticos y forma de administración, los autores revisan todos estos aspectos, basándose en una bibliografía sumamente actualizada. Posteriormente, en otro artículo de estos mismos autores, se evaluarán los cuidados de enfermería propios de la oxigenoterapia domiciliaria (AU)

[A health study of older persons in Extremadura: drug taking and the most frequent chronic diseases]. / Estudio de salud de las personas mayores en Extremadura: consumo de fármacos y patologías crónicas más frecuentes.

BACKGROUND: To ascertain the use of drugs among the non-institutionalised elderly population, the factors related to polypharmacy and pinpointing the relationship thereof with chronic diseases. METHODS: Cross-sectional epidemiological study by means of door-to-door survey. The population systematically selected totalled 960 individuals age 65-93. The questionnaire included demographic data, self-assessed health condition, quantitative and qualitative aspects of the use of medications, chronic diseases and assessment of functional ability. RESULTS: 91.62% of those surveyed were taking medication, a greater number of females (p < 0.002) than males. The medications taken to the greatest extent were blood pressure drugs (42.4%), analgesics (38.7%) and heart drugs (24.8%). Drugs were used to a greater extent among the oldest age group (p < 0.0001), those having the lowest educational level (p < 0.001), those with impaired eyesight and hearing (p < 0001), those having the lowest social status (p < 001), more contacts with the health care services (p < 0001), worse self-assessed health condition (p < 0001), a greater number of chronic diseases (p < 0.0001) and depressive disorders (p = 0.004). The linear regression analysis revealed a positive relationship between the number of medications taken and the number of chronic diseases (r = 0.518; p < 0.0001). Females report worse health conditions (p < 0.05). The variables analyzed with regard to polypharmacy by means of logistic regression are age (over age 75; OR = 1.1478), three or more chronic diseases (OR = 1.83) and poor self-assessed health condition (OR = 1.22). CONCLUSIONS: Physical checkups on the elderly must include a review of the medications being taken, especially among those over age 75 who have a worse self-assessed health condition and a larger number of chronic diseases.

[Subcutaneous drug administration. Indications for the use in terminal patients]. / Vía subcutánea. Indicaciones de uso en el enfermo terminal.

The preferred methods to administer medicines to the sick are oral, under the tongue, or rectal; but in the case of the terminally ill patient, we may encounter the problem that the drugs which they tend to require do not come in either of these preferred administering methods since these patients symptoms and problems demand complex responses. In these cases, the subcutaneous way winds up being highly recommended; therefore, the authors present the pharmacological bases of this method, they describe continuous subcutaneous perfusion, and all those aspects of this method which might be interesting to the professionals who employ it.