Publication describes the diagnosis and management of cellulitis
Cellulitis is a frequently encountered condition, but remains a challenging clinical entity” Sullivan and de Barra (2018). Abstract: Cellulitis is a frequently encountered condition, but remains a challenging clinical entity. Under and overtreatment with antimicrobials frequently occurs and mimics cloud the diagnosis. Typical presentation, microbiology and management approaches are discussed. Reference: Sullivan, T. and de […]
Risk factors for bloodstream infections in cancer patients
The aim of this study was to evaluate the clinical characteristics and risk factors associated with mortality in cancer patients with bloodstream infections (BSI), analyzing multidrug resistant bacteria (MDRB)” Islas-Muñoz et al (2018). Abstract: OBJECTIVE: The aim of this study was to evaluate the clinical characteristics and risk factors associated with mortality in cancer patients […]
Unusual outcome of femoral vein PICC placement
We describe a case of a 9-month-old boy with complex congenital heart disease (heterotaxy syndrome, polysplenia type) who underwent pulmonary artery banding to reduce pulmonary blood flow to control heart failure symptoms. PICC was placed in the left femoral vein during the postoperative period.” Extract: “The peripherally inserted central catheter (PICC) is used as a […]
What is the impact of placing a tunnelled midline catheter?
The placement of the tunnelled midline catheter is shown to be a safe and effective way to ensure vascular access for almost 2 months” Fabiani et al (2018). Abstract: INTRODUCTION: A safe, largely used practice for difficult venous access patients is positioning a catheter in deeper veins under ultrasound guide. However, the risk of complications is […]
Procedural and documentation variations in intravenous infusion administration
To address this we investigated the prevalence of procedural and documentation deviations in IV infusion administration and explored variability in policy and practice across different hospital trusts” Furniss et al (2018). Abstract: BACKGROUND: Procedural and documentation deviations relating to intravenous (IV) infusion administration can have important safety consequences. However, research on such deviations is limited. […]
Errors and discrepancies in the administration of intravenous infusions
Errors and discrepancies are relatively common in everyday infusion administrations but most have low potential for patient harm” Lyons et al (2018). Abstract: INTRODUCTION: Intravenous medication administration has traditionally been regarded as error prone, with high potential for harm. A recent US multisite study revealed few potentially harmful errors despite a high overall error rate. […]
Guidelines for preventing the transmission of infections in hemodialysis facilities
This special report summarizes the key recommendations from the Korean clinical practice guidelines for preventing the transmission of infections in hemodialysis facilities” Park et al (2018). Abstract: Patients receiving hemodialysis are vulnerable to infectious diseases due to their impaired immunity and high risk of exposure to pathogens. To protect patients, staff, and visitors from potential […]
Can you avoid placing that central venous catheter?
The purpose of this retrospective study is to identify the unnecessary application of central venous catheter placement and determine the factors associated with the unnecessary application of central venous catheter placement” Uemura et al (2018). Abstract: BACKGROUND AND OBJECTIVES: Perioperative physicians occasionally encounter situations where central venous catheters placed preoperatively turn out to be unnecessary. […]
Impact of defaulting to single lumen peripherally inserted central catheters
Changing the default for peripherally inserted central catheters (PICCs) ordered from non-critical care units to single-lumen devices resulted in a sustained reduction in PICC-related complications” Lam et al (2018). Abstract: Changing the default for peripherally inserted central catheters (PICCs) ordered from non-critical care units to single-lumen devices resulted in a sustained reduction in PICC-related complications. […]
Quality improvement protocol to reduce neonatal CLABSI rates
Therefore, we intend to introduce evidence-based CLABSI prevention package in our practice to improve CLABSI rates in our NICU within limited resources” Hussain et al (2017). Abstract: INTRODUCTION: Central line-associated bloodstream infections (CLABSI) are the most important cause of morbidity and mortality in critically ill patients. Evidence-based interventions when used in form of a bundle […]
Recanalization of occluded veins in a parenteral nutrition-dependent children
We propose a new paradigm that uses these techniques to prevent access site exhaustion in patients who do not respond to anticoagulation therapy. This approach may reduce morbidity and mortality in patients with chronic access needs and the need for intestinal transplantation in patients with intestinal failure” Sullivan et al (2018). Abstract: Central venous thromboses […]
Creating a multidisciplinary dialysis access program
We conclude that a formalized access program decreases catheter rates, central line-associated bloodstream infection, and the resultant hospitalizations, mortality, and costs” Rosenberry et al (2018). Abstract: INTRODUCTION: Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have <12% of their patients utilizing central venous catheters for hemodialysis treatments. On the Eastern […]
Relocation of blood gas laboratory to the emergency department
Emergency physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL)” Brazg et al (2018). Abstract: Importance: Emergency physicians often rely on Lactic Acid (LA) values to make important […]
Skin disinfection before CVC insertion in patients receiving intensive chemotherapy
We aimed to compare the effectiveness of 1% chlorhexidine gluconate in 70% alcohol (CH) vs. PI for skin disinfection before CVC insertion in patients receiving intensive chemotherapy” Ohtake et al (2018). Abstract: A central venous catheter (CVC) is a catheter placed into a large vein, and is used for chemotherapy administration. However, there is little […]
Article explains laboratory tests of renal function
In this article we will discuss tests frequently used to assess renal function” Stewart and Pasha (2018). Abstract: The kidneys are vital organs in the management of fluid balance, waste product removal, electrolyte homeostasis, acid–base balance and endocrine function. Waste products removed by the kidney include urea, uric acid, creatinine and other foreign products with […]
Interventional management of central vein occlusion in patients with PICC placement
This study evaluated the incidence of central vein occlusion (CVO) and analyzed the interventional management for CVO during peripherally inserted central catheter (PICC) placement to suggest an adequate management protocol to ensure the success and patency of PICCs” Yeon et al (2018). Abstract: OBJECTIVE: This study evaluated the incidence of central vein occlusion (CVO) and […]
Central venous catheter use among haemodialysis patients in the Irish health system
The goal of this study was to determine the prevalence and variation in CVC use across centres in the Irish health system” Hussein et al (2018). Abstract: BACKGROUND: Central venous catheters (CVC) are associated with substantial morbidity and mortality among patients undergoing haemodialysis (HD), yet they are frequently used as the primary vascular access for […]
Ultrasound guidance for internal jugular vein cannulation in PICU
We investigated whether ultrasound guidance was advantageous over the anatomical landmark technique when performed by inexperienced paediatricians” de Souza et al (2018). Abstract: OBJECTIVE: We investigated whether ultrasound guidance was advantageous over the anatomical landmark technique when performed by inexperienced paediatricians. DESIGN: Randomised controlled trial. SETTING: A paediatric intensive care unit of a teaching hospital. […]
How much variation in central venous catheter insertion technique?
Surgery residents do not strictly adhere to the guidelines for CVC and CT insertions, and there is substantial variation in the practice of the procedures, which may contribute to complications associated with these procedures” Cho et al (2018). Abstract: OBJECTIVES: Central venous catheter (CVC) and chest tube (CT) insertions are common bedside procedures frequently performed […]
Intraosseous versus intravenous access in pediatric septic shock
The IO route was successfully secured in all cases with a significant shorter time of vascular access insertion, shorter length of stay and reduction in mortality in IO group vs. IV group (p = 0.001, 0.045, 0.002, respectively)” El-Nawawy et al (2018). Abstract: The cornerstone of emergency management of sepsis is early, goal-directed therapy. The purpose […]
Is chest X-ray necessary after ultrasound-guided central venous line placement?
Routine CXR consumes valuable time and resources (≅$155,000 annually) and rarely affects management. Selection should be guided by clinical factors” Woodland et al (2018). Abstract: BACKGROUND: Central venous catheters (CVC) can be useful for perioperative monitoring and insertion has low complication rates. However, routine post insertion chest X-rays have become standard of care and contribute […]
Treatment of superior vena cava syndrome through catheter-directed thrombolysis
This case shows that catheter-directed thrombolysis may be used as a safe treatment for catheter-induced acute SVC syndrome in patients who have undergone catheter insertion in the central vein” Ghanavati et al (2017). Abstract: Superior vena cava (SVC) syndrome is a medical condition resulting from the obstruction of the blood flow through the large central […]
Antimicrobial lock solutions for preventing catheter-related infections in haemodialysis
To assess the efficacy and safety of antimicrobial (antibiotic, non-antibiotic, or both) catheter lock solutions for preventing CRI in participants undergoing HD with a CVC” Arechabala et al (2018). Abstract BACKGROUND: Patients undergoing haemodialysis (HD) through a central venous catheter (CVC) are exposed to several risks, being a catheter-related infection (CRI) and a CVC lumen […]
Impact of pediatric outpatient parenteral antibiotic therapy
Our data suggest that p-OPAT is safe and effective, with the potential to offer considerable savings for the healthcare economy through reduced length of inpatient stay” Patel et al (2018). Abstract: BACKGROUND: Recent advances in outpatient parenteral antibiotic therapy (OPAT) have largely focused on adult practice, and there are few published data on the safety […]
Complications in the central venous catheterization in children under 18 years of age
To describe the frequency of immediate complications of central venous catheterisation guided by the ultrasound in a general university hospital, compared to the anatomical landmarks technique in children less than 18years of age” Rivera-Tocancipá et al (2018). Abstract: INTRODUCTION: The insertion of a central venous line in children and adolescents is technically more difficult, due […]
The venous patterns of the cubital fossa is mapped in this study
The present study aims to analyze the venous pattern of the cubital fossa among individuals from Brazil” Pires et al (2018). Abstract: Venous punctures are among the most common procedures performed by healthcare professionals. In particular, the cubital fossa is the site where the venous accesses are frequently made due to the number of superficial […]
Continuous passive disinfection cap for the decontamination of needle-free connectors
The objective of this study was to determine if a continuous passive disinfection cap is as effective as standard cleaning for the microbial decontamination of injection ports of two types of needle-free connectors” Casey et al (2018). Abstract: Background: The optimal decontamination method for needle-free connectors is still unresolved. The objective of this study was […]
Effect of central line bundle compliance on CLABSI rates
This study provides direct evidence that completing all CL bundle components perfectly is essential for preventing CLABSIs. Customized education should be provided, according to specific weaknesses of bundle performance” Lee et al (2018). Abstract: PURPOSE: The present study aimed to evaluate the effect of central line (CL) bundle compliance on central line-associated bloodstream infections (CLABSIs) […]
Sustaining CLABSI reduction in neonatal intensive care
We describe our experience with lessons learned, with an emphasis on the areas of difficulty during implementation of the bundle elements and the strategies and tools we utilized to overcome them” Hawes and Lee (2018). Abstract: Central venous catheters are commonly used for the provision of parenteral nutrition and medications for critically ill neonates in […]
Effects of thickness of muscle and subcutaneous fat on efficacy of IM injection sites
Intramuscular injections given at the dorsogluteal and ventrogluteal sites are intended for the gluteus maximus and gluteus medius muscles, respectively. However, little research has confirmed the reliability of these sites for the presence and thickness of the target and other muscles, and subcutaneous fat” Elgellaie et al (2018). Abstract: Intramuscular injections given at the dorsogluteal […]