Patency of radial arterial catheters.

BACKGROUND: Data on the influence of flush methods, blood-sampling methods, and site location on the patency of radial arterial catheters used for pressure monitoring are sparse. OBJECTIVES: To determine the effects of flush and blood-sampling methods, insertion site, and sex of patients on catheter patency. METHODS: In a randomized trial, 174 patients requiring radial arterial pressure monitoring were assigned to 4 groups: fast flush as needed and nonwaste blood sampling; fast flush as needed and waste blood sampling; fast flush every 4 hours and waste blood sampling; and fast flush every 4 hours and nonwaste blood sampling. All site locations were evaluated for patency, and all monitoring systems were maintained with isotonic sodium chloride solution. RESULTS: Nonpatent catheters were 4.23 times more likely in patients with insertion sites 3 cm or higher above the bend of the wrist than in patients with lower sites (P = .01). Duration of patency did not differ between catheters maintained with fast flush every 4 hours and those flushed as needed or between catheters according to the method of blood sampling. Women were 3.05 times more likely than men to have nonpatent catheters (P = .02). With insertion sites 3 cm or higher above the radiocarpal joint, nonpatency was 7.3 times more likely in women than in men (P < .001). CONCLUSIONS: Insertion sites closest to the bend of the wrist increase chances of maintaining patency. Catheters can be maintained with as-needed flushes, and either waste or nonwaste blood sampling can be used.

The Florida "truth" anti-tobacco media evaluation: design, first year results, and implications for planning future state media evaluations.

OBJECTIVES: To outline the design and present selected findings from the evaluation of a state counter-advertising, anti-tobacco media campaign. The appropriateness of the design for states developing media evaluations is discussed. DESIGN: Four cross sectional, telephone surveys of the 12--17 year old population were used to track and monitor advertising and campaign awareness, confirmed awareness, and receptivity. The Florida baseline and one year surveys were used with two parallel national surveys in a quasi-experimental design to assess attitude and smoking related behaviour change attributable to the campaign. MEASURES: Awareness was measured by self report, confirmed awareness by unaided description, and receptivity by self reports of how well advertisements were liked, talked to friends about, and made one think about whether or not to smoke. Eleven attitude and three smoking behaviour items for Florida (treatment) and a national (control) population were compared at baseline and after 12 months. RESULTS: Significant increases in ad specific awareness, confirmed, receptivity, and campaign awareness, and confirmed awareness were reached by the sixth week. They continued to rise through the first year. No attitude and only minor behaviour differences were noted between the treatment and comparison populations at baseline. By the end of the first year, Florida youth had stronger anti-tobacco attitudes and better behaviour patterns than the comparison population. CONCLUSIONS: The industry manipulation strategy used in the Florida campaign resulted in high rates of recall, significant changes in attitudes/beliefs, and reduced rates of smoking behaviour among youth.