Challenging the distal-to-proximal cannulation technique for administration of anti-cancer therapies : a prospective cohort study

Background: Distal-to-proximal technique has been recommended for anti-cancer therapy administration. There is no evidence to suggest that a 24-hour delay of treatment is necessary for patients with a previous uncomplicated venous puncture proximal to the administration site. Objectives: This study aims to identify if the practice of 24-hour delay between a venous puncture and subsequent cannulation for anti-cancer therapies at a distal site is necessary for preventing extravasation. Methods: A prospective cohort study was conducted with 72 outpatients receiving anti-cancer therapy via an administration site distal to at least one previous uncomplicated venous puncture on the same arm in a tertiary cancer centre in Australia. Participants were interviewed and assessed at baseline data before treatment and on day 7 for incidence of extravasation/phlebitis. Results: Of 72 participants with 99 occasions of treatment, there was one incident of infiltration (possible extravasation) at the venous puncture site proximal to the administration site and two incidents of phlebitis at the administration site. Conclusions: A 24 hour delay is unnecessary if an alternative vein can be accessed for anti-cancer therapy after a proximal venous puncture. Implications for practice: Extravasation can occur at a venous puncture site proximal to an administration site in the same vein. However, the nurse can administer anti-cancer therapy at a distal site if the nurse can confidently determine the vein of choice is not in any way connected to the previous puncture site through visual inspection and palpation.

Effect of simulated rock dumping on geotextile

The use of geotextiles in coastal structures such as revetments and bund walls has become a common practice. The performance of these structures during their lifetime depends on the durability of geotextile used. During construction of these coastal structures, geotextiles are subjected to a drop load with high impact stress and that can damage the geotextile. In the current design practice, index tests are insufficient in predicting the performance of the geotextile. This puts the stability and performance of the coastal structures at risk. The current geotextile design guidelines are based on index tests and there is no standard procedure to account for the potential loss in the geotextile’s mechanical properties during installation (construction).This study aims to develop a standard procedure to estimate the properties of geotextile after its installation and using these properties for designing the performance of these structures. This paper describes the laboratory method of simulating large scale rock dumping on non-woven geotextiles and how to quantify the retained strength of damaged geotextiles. Results show that the reduction in retained strength of geotextile could extent up to 26% during installation.