Compatibility of prolonged infusion antibiotics during Y-site administration.

BACKGROUND: Antimicrobial resistance is a threat to global public health. The use of prolonged infusions in the hospital setting for certain antimicrobials is widely increasing in order to improve their efficacy and safety, including resistance development. Due to limited vascular access, it is important to clarify whether they can be infused through the same line with other drugs during Y-site administration. AIM: The aim of this review is to update and summarize the evidence on Y-site compatibility of antibacterial agents administered as prolonged infusions in intensive care units (ICUs). STUDY DESIGN: A literature review of PubMed, EMBASE and Trissel's Handbook on Injectable Drugs databases was conducted on the compatibility of selected antimicrobials administered simultaneously at a Y-site connection with parenteral nutrition and other widely used drugs in ICUs. All articles published up to October 30, 2021, in English or Spanish were included, regardless of the type of publication (original articles, case reports, letters, etc.). Eligible antimicrobials were those that can be administered as prolonged infusions: ceftazidime, cefepime, piperacillin/tazobactam, meropenem, ceftolozane/tazobactam, ceftaroline, cloxacillin, ceftobiprole, vancomycin and fosfomycin. RESULTS: A total of 1302 drug-to-drug potential combinations were explored, 196 (15.05%) were found to be incompatible, and in 541 (41.55%), data were not available. The results were presented in a simple 2-dimensional consultation chart as a quick reference for health care professionals. CONCLUSIONS: This review provides useful and reliable information on the compatibility of antimicrobials administered as Y-site infusion with other drugs commonly used in the critical setting. This review contributes to patient safety in nursing practice. RELEVANCE TO CLINICAL PRACTICE: To our knowledge, this is the first review on Y-site compatibility of antimicrobials used as prolonged infusions with other commonly used drugs, including anti-emetics, analgesics and anti-epileptic and parenteral nutrition. The results of the current review need to be addressed to promote the knowledge sharing between health professionals and improve the quality and safety of patients. We believe that this review may serve as a simple and effective 2-dimensional updated drug-to-drug compatibility reference chart for critical care nurses.

Transporte aéreo sanitario del paciente adulto crítico / Medical air transport for the critically ill adult patient

La progresiva implantación de los servicios de emergencias ennuestra sociedad, como consecuencia de la gran demanda de asistenciasanitaria en el lugar donde se producen los accidentes, hacambiado la concepción del transporte sanitario: se ha pasado de“transportar para salvar” a “salvar para luego transportar”.El traslado del paciente en un medio de transporte aéreo requiereunos cuidados específicos derivados de su situación crítica y de lascaracterísticas propias del medio utilizado.En este trabajo se expone una clasificación de los medios aéreos,que han pasado de ser rudimentarios globos aerostáticos a sofisticadasaeronaves presurizadas/no presurizadas (helicópteros y aviones)y se describe un protocolo de los cuidados necesarios antes,durante y después del traslado aéreo de un paciente adulto críticohospitalizado

The progressive implantation of emergency services in our society,as a result of the high demand for healthcare at the site wherethe accidents occur, has changed the idea of medical transportation,going from “to transport to safe a live” to “safe a life andthen to transport”.The transportation of the patient in an air transportation systemrequires specific care derived from a critical situation and theactual characteristics of the used transportation mode.This paper presents a classification of air means that have gonefrom being rudimentary aerostatic balloons to sophisticated pressurised/non-pressurised aircrafts (helicopters and airplanes). Thepaper also describes a protocol of the appropriate patient carebefore, during and after a critically ill hospitalised adult patient islifted by air