Central Venous Catheters

Indications for central venous cannulation in critically ill patients have increased dramatically, but central venous access has the drawbacks of morbidity and a scarcity of experienced operators. Ultrasound-guided peripheral venous access offers a solution, in that it reduces morbidity and can be performed by a dedicated nursing team. The aim of this book is to teach the fundamentals of this emerging technique. Advice is provided on choice of materials; maneuvers for positioning of peripherally inserted central venous catheters (PICCs), techniques for evaluation of PICC tip placement; prevention, diagnosis, and management of complications; and organization of a dedicated team within a hospital or a supportive care program. Legal and economic issues are also considered. The book will be of interest to a wide range of professionals, including nutritionists, oncologists, anesthesiologists, surgeons, registered nurses, nurse practitioners, physicians, physician assistants, and radiologists.

This book addresses all the issues a patient may experience prior to receiving a VAD. Selection of equipment, practical aspects of technique, the pros and cons of the various veins, and modifications of technique for certain circumstances are examined. Covereage also includes the roles played by radiologists, anaesthetists, surgeons, nurses, and other team memebers. Throughout the chapters a reference is made to the IV Therapy Standards published by the Royal College of Nursing IV Therapy Forum in 2003. Each chapter is evidence based and fully referenced.

This atlas is designed to provide an all-inclusive resource that describes step by step how to perform the essential bedside procedures required to provide optimal care to the critically ill patient. Detailed descriptions of these procedures, with sequential photographs depicting each critical step, provide an in depth understanding of the anatomy, critical technical steps and common pitfalls to both military and civilian trainees. For the advanced professional operator, this atlas will provide a rapid refresher of the critical steps and is an excellent teaching resource, based on the decades of collective experience accumulated by the authors. The top quality photographs of perfused and ventilated cadavers makes this atlas a standard reference for surgeons, critical care physicians, nurses and all critical care professionals.

Since their first application in 1982, Totally Implantable Venous Access Devices (TIVADs) have become increasingly important in the clinical practice, as more intensive chemotherapy and parenteral treatments have come into use. At this time, there is objective evidence that TIVADs are a safe, effective strategy for long-term venous access; they play a significant role throughout the management of the oncology patient, as they are needed in the initial phases for active treatments as well as in the last stages for palliative measures, making possible repeated administration of chemotherapeutic vesicant agents, nutrients, antibiotics, analgesics, and blood products. According to a number of prospective studies, use of TIVADs is associated with a significant complication rate (10% to 25% of all patients). Evidence-based data support that most complications are directly related to inappropriate technique of placement and/or nursing care, sometimes leading to TIVAD loss, significant morbidity, increased duration of hospitalization, and additional medical cost. A group of world-renowned experts - both in the clinical and research fields – contributed to this volume, whose aim is to provide clinicians, nurses and medical students with a multidisciplinary, full update on these devices, as long term central venous access can no be longer considered a routine matter, and serious complications can be maintained at a very low level only if strict adherence to a well-defined protocol of surgical technique and of catheter care is maintained.

This full-color atlas presents over 1200 images from one of the largest trauma centers in North America. Photos, x-rays and illustrations depicting a variety of common and rare traumatic injuries are accompanied by recommendations and advice from a multidisciplinary group of experienced trauma care providers.

Indications for central venous cannulation in critically ill patients have increased dramatically, but central venous access has the drawbacks of morbidity and a scarcity of experienced operators. Ultrasound-guided peripheral venous access offers a solution, in that it reduces morbidity and can be performed by a dedicated nursing team. The aim of this book is to teach the fundamentals of this emerging technique. Advice is provided on choice of materials; maneuvers for positioning of peripherally inserted central venous catheters (PICCs), techniques for evaluation of PICC tip placement; prevention, diagnosis, and management of complications; and organization of a dedicated team within a hospital or a supportive care program. Legal and economic issues are also considered. The book will be of interest to a wide range of professionals, including nutritionists, oncologists, anesthesiologists, surgeons, registered nurses, nurse practitioners, physicians, physician assistants, and radiologists.

This Open access book offers updated and revised information on vessel health and preservation (VHP), a model concept first published in poster form in 2008 and in JVA in 2012, which has received a great deal of attention, especially in the US, UK and Australia. The book presents a model and a new way of thinking applied to vascular access and administration of intravenous treatment, and shows how establishing and maintaining a route of access to the bloodstream is essential for patients in acute care today. Until now, little thought has been given to an intentional process to guide selection, insertion and management of vascular access devices (VADs) and by default actions are based on crisis management when a quickly selected VAD fails. The book details how VHP establishes a framework or pathway model for each step of the patient experience, intentionally guiding, improving and eliminating risk when possible. The evidence points to the fact that reducing fragmentation, establishing a pathway, and teaching the process to all stakeholders reduces complications with intravenous therapy, improves efficiency and diminishes cost. As such this book appeals to bedside nurses, physicians and other health professionals.