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Nonpharmacological methods of pain reduction during venous cannulation

opat

This study aims to evaluate the role of 3 different nonpharmacological measures such as Valsalva maneuver, flash of light, and distraction method in attenuation of pain during venous cannulation” Shivashankar et al (2018). Abstract: BACKGROUND: Establishing an intravenous access is indispensable for safe administration of anesthesia. Most of the times, it is executed without any analgesia […]

Central venous or peripheral administration of sufentanil

intravenous

Opioid-induced cough (OIC) is one of the most common complications of opioids during anesthesia induction. This study was designed to assess the incidence of OIC mediated by different intravenous route” He et al (2018). Abstract: BACKGROUND: Opioid-induced cough (OIC) is one of the most common complications of opioids during anesthesia induction. This study was designed […]

Colombian survey of ultrasound guidance for central venous catheterisation

jugular central line

US guidance is not a common technique used for CVC by Colombian anaesthesiologists; an important barrier for its use is lack of equipment” Calvache et al (2018). Abstract: QUALITY PROBLEM OR ISSUE: Ultrasound (US) is a widely propagated medical technology. Anaesthesiologists increase procedural safety by using US techniques, but training and availability are essential for […]

Ultrasound-guided placement of long peripheral cannulas in children

Ultrasound Vascular Access

The aim of this study was to compare success rates, dwell times and complications of peripheral venous long cannulas (LCs) inserted under ultrasound guidance with those of SCs in children” Paladini et al (2018). Abstract: OBJECTIVES: Most children admitted to the emergency department (ED) require peripheral venous access (PVA), which is often difficult to perform […]

Pilot randomized controlled trial comparing PICC materials in pediatrics

CLABSI

Our primary aim was to evaluate the feasibility of a large randomized controlled efficacy trial of PICC materials and design to reduce PICC complication in pediatrics” Kleidon et al (2018). Abstract: BACKGROUND: Despite the popularity of peripherally inserted central catheters (PICCs), recent literature highlights their potential injurious complications. Innovative PICC materials have been developed to […]

Publication describes the diagnosis and management of cellulitis

cvc

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

clabsi outcomes

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

Peripheral IV

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?

IV flush

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

peripheral iv catheter

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

Antibiotic infusion

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

CLABSI reduced

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?

Ultrasound

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

hand hygiene

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

neonatal picc

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

paediatric BSI

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

picc line

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

intraosseous infusion sites

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

syringe pump

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

Venipuncture

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

picc teams

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

dialysis access

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

intravenous cannulation

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?

Ultrasound Vascular Access

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

CLABSI

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?

central tip

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

Intracavity ECG

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

CLABSI reduced

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

child iv

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

Ultrasound

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 […]