Consensus needed for VTE prophylaxis in burns patients
New research suggests VTE prophylaxis following burn injury in adult patients reduces risk of in-hospital mortality but debate about the effectiveness of the therapy for burns patients means many miss out on the treatment, say researchers.
In research published in Burns & Trauma investigators from Monash University say burn patients are at increased risk of thromboembolism because of systemic hypercoagulability, intimal damage and prolonged periods of bed rest. Their retrospective analysis is the first study to explore variation in the use of VTE prophylaxis, and its association to in-hospital outcomes, in Australian and New Zealand burn centres.
The team looked at burns registry data for more than 5000 adult patients admitted to dedicated burns treatment centres in Australia and New Zealand over a two year period.
Overall, 80% of patients received some kind of VTE prophylaxis during their acute admission but investigators found ‘substantial variation’ between units in the proportion of patients who received treatment ranging from from 48.6% to 94.8%.
While the rate of in-hospital mortality (<1%) and non-fatal VTE events (approximately 3%) were low researchers found use of VTE prophylaxis was strongly associated with reduced odds of in-hospital mortality (adjusted odds ratio = 0.21; 95% CI, 0.07–0.63; p = 0.006).
Patients who received prophylaxis were older and sustained larger and deeper burns than those who did not receive prophylaxis. Patients who were admitted to the ICU, sustained an inhalation injury and had a burn injury affecting their leg and/or foot were also more likely to have received prophylaxis.
Investigators say they will engage with burns units to further explore differences in VTE prophylaxis use and develop best practice guidelines to improve patient outcomes.
Home blood transfusion services safe
A review of a nurse-led home blood transfusion service in Adelaide reveals the system is safe for those with a medically stable, chronic condition who are unable to attend a hospital setting.
The service was associated with a <1% adverse event rate and researchers reported few failures in the system used to provide the service.
The most common complication reported by the service were adverse events associated with the vascular access device, particularly difficulty cannulating the individual (n= 82, 54%), which was also the reason for most blood product wastage.
Meanwhile, from 1790 episodes of care involving 533 participants, there were 13 cases of transfusion reaction (incident rate (IR) 0.7% ; 95% CI 0.43-1.25%) five of which were severe, resulting in the cessation of the blood transfusion and further medical review or hospital admission (IR 0.28%; 95% CI 0.12-0.68).
Investigators suggest RNs consider ultrasound to help with PIVC insertion, which would improve patient experience.
New Facebook group open for Lymphoma patients
Lymphoma Australia have established a new Facebook forum for patients and carers affected by lymphoma. The group, called Lymphoma DownUnder, is a place for patients to connect, share tips and experiences, and receive support.
The private group is moderated by Lymphoma Australia. You can direct patients and carers to the group by following this link.