title: Challenging the distal-to-proximal cannulation technique for administration of anticancer therapies: a prospective cohort study.
abstract: BACKGROUND
  Distal-to-proximal technique has been recommended for anticancer therapy administration. There is no evidence to suggest that a 24-hour delay of treatment is necessary for patients with a previous venous puncture proximal to the administration site.
  
  
  OBJECTIVE
  This study aims to identify if the practice of 24-hour delay between a venous puncture and subsequent cannulation for anticancer therapies at a distal site is necessary for preventing extravasation.
  
  
  METHODS
  A prospective cohort study was conducted with 72 outpatients receiving anticancer therapy via an administration site distal to at least 1 previous venous puncture on the same arm in a tertiary cancer center 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 1 incident of infiltration (possible extravasation) at the venous puncture site proximal to the administration site and 2 incidents of phlebitis at the administration site.
  
  
  CONCLUSIONS
  A 24-hour delay is unnecessary if an alternative vein can be accessed for anticancer therapy after a proximal venous puncture.
  
  
  CONCLUSIONS
  Infiltration can occur at a venous puncture site proximal to an administration site in the same vein. However, the nurse can administer anticancer therapy at a distal site if the nurse can confidently determine that the vein of choice is not in any way connected to the previous puncture site through visual inspection and palpation.
authors: Cancer Care Services, Royal Brisbane and Women's Hospital, Queensland, Australia. r.chan2@uq.edu.au
authors: Raymond Javan
authors: RJ
authors: Chan
authors: Alison
authors: A
authors: Alexander
authors: Maree
authors: M
authors: Bransdon
authors: Joan
authors: J
authors: Webster
authors: Brett Gordon Maxwell
authors: BG
authors: Hughes
authors: Leisa
authors: L
authors: Brown
authors: Therese
authors: T
authors: Graham
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002404:Catheterization / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000451:nursing; D010689:Phlebitis / Q000517:prevention & control; D011446:Prospective Studies; D036301:Qualitative Research; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents