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Central line placement

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https://www.readbyqxmd.com/read/29785148/the-use-of-augmented-reality-glasses-in-central-line-simulation-see-one-simulate-many-do-one-competently-and-teach-everyone
#1
Cynthia Y Huang, Jonathan B Thomas, Abdullah Alismail, Avi Cohen, Waleed Almutairi, Noha S Daher, Michael H Terry, Laren D Tan
Objective: The aim of this study was to investigate the feasibility of using augmented reality (AR) glasses in central line simulation by novice operators and compare its efficacy to standard central line simulation/teaching. Design: This was a prospective randomized controlled study enrolling 32 novice operators. Subjects were randomized on a 1:1 basis to either simulation using the augmented virtual reality glasses or simulation using conventional instruction...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29777311/sufficiency-of-curing-in-high-viscosity-bulk-fill-resin-composites-with-enhanced-opacity
#2
Nicoleta Ilie
OBJECTIVES: The study aims analyzing if improved opacity in modern high-viscosity bulk-fill resin composites (BF-RBC) contradicts with the sufficiency of curing and to assess material's tolerance to less ideal curing conditions. MATERIALS AND METHODS: Simulated large cavities (10 × 6) mm were filled in one increment with three BF-RBCs (Filtek One, FO; Tetric Evo Ceram Bulk Fill, TEC-BF; SonicFill2, SF2). One central and two peripheral (4 mm apart from the center) micromechanical property line-profiles (HV, Vickers hardness; YHU , indentation modulus) were measured in 0...
May 18, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29753159/defining-incidence-and-risk-factors-for-catheter-associated-bloodstream-infections-in-an-outpatient-adult-hematopoietic-cell-transplant-program
#3
Marissa K McDonald, Kathryn A Culos, Katie S Gatwood, Caleb Prow, Heidi Chen, Bipin N Savani, Michael Byrne, Adetola A Kassim, Brian G Engelhardt, Madan Jagasia, Gowri Satyanarayana
BACKGROUND: Allogeneic hematopoietic cell transplant (HCT) patients are at an increased risk of developing central line-associated bloodstream infections (CLABSIs) due to prolonged periods of myelosuppression, immunosuppression, and indwelling catheter days. CLABSIs are among the most serious complications in HCT recipients and can lead to prolonged hospitalizations, intensive care unit (ICU) admissions, lengthy antimicrobial therapies, and increased mortality. There is a lack of data regarding the incidence and risk factors associated with the development of CLABSIs in the HCT population undergoing outpatient transplantation...
May 9, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29742636/malposition-of-a-central-venous-catheter-in-trauma-confirmation-of-placement-prevents-complications
#4
Steven D Hobbs
This case study presents the inadvertent catheterization of a traumatic hemopneumothorax. A 22-year-old man sustained multiple stab wounds, including the left chest with a resultant hemopneumothorax. Upon arrival at a Level 1 trauma center, an ipsilateral subclavian central catheter was placed, blood was freely aspirated, and because of the patient's critical status, immediately utilized for resuscitation prior to line verification by radiography. A short time later, the catheter was felt to be malpositioned, most likely in the left intrathoracic space, and removed...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29707506/airway-stents
#5
Erik Folch, Colleen Keyes
Stents and tubes to maintain the patency of the airways are commonly used for malignant obstruction and are occasionally employed in benign disease. Malignant airway obstruction usually results from direct involvement of bronchogenic carcinoma, or by extension of carcinomas occurring in the esophagus or the thyroid. External compression from lymph nodes or metastatic disease from other organs can also cause central airway obstruction. Most malignant airway lesions are surgically inoperable due to advanced disease stage and require multimodality palliation, including stent placement...
March 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29669611/needle-thoracostomy-does-changing-needle-length-and-location-change-patient-outcome
#6
Lori A Weichenthal, Scott Owen, Geoffory Stroh, John Ramos
BACKGROUND: Needle thoracostomy (NT) is a common prehospital intervention for patients in extremis or cardiac arrest due to trauma. The purpose of this study is to compare outcomes, efficacy, and complications after a change in policy related to NT in a four-county Emergency Medical Services (EMS) system with a catchment area of greater than 1.6 million people. METHODS: This is a before and after observational study of all patients who had NT performed in the Central California (USA) EMS system...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29665190/comparison-of-emergency-medicine-malpractice-cases-involving-residents-to-non-resident-cases
#7
Kiersten L Gurley, Shamai A Grossman, Margaret Janes, C Winnie Yu-Moe, Ellen Song, Carrie D Tibbles, Nathan I Shapiro, Carlo L Rosen
BACKGROUND: Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. OBJECTIVES: To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. METHODS: We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013...
April 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29660009/critical-care-in-the-military-health-system-a-24-h-point-prevalence-study
#8
Raymond Fisher, Christopher J Colombo, Cristin A Mount, Elizabeth A Mann-Salinas, Adam W Bostick, Konrad Davis, James K Aden, Kevin K Chung, Mary S McCarthy, Jeremy C Pamplin
Background: Healthcare expenditures are a significant economic cost with critical care services constituting one of its largest components. The Military Health System (MHS) is the largest, global healthcare system of its kind. In this project, we sought to describe critical care services and the patients who receive them in the MHS. Methods: We surveyed 26 military treatment facilities (MTFs) representing 38 critical care services or intensive care units (ICUs)...
April 11, 2018: Military Medicine
https://www.readbyqxmd.com/read/29627658/routine-chest-x-ray-is-unnecessary-after-ultrasound-guided-central-venous-line-placement-in-the-operating-room
#9
David C Woodland, C Randall Cooper, M Farzan Rashid, Vilma L Rosario, Paul David Weyker, Joshua Weintraub, Stuart Bentley-Hibbert, Michael D Kluger
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 to health care costs with limited impact on patient management. METHODS: 200 patient charts who underwent pancreaticoduodenectomy with central line placement and early line removal were reviewed for clinical complications related to central line placement as well as radiographic evidence of malpositioning...
March 28, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29607221/a-rare-central-venous-catheter-malposition-in-a-10-year-old-girl
#10
Ali Movafegh, Alireza Saliminia, Reza Atef-Yekta, Omid Azimaraghi
Central venous catheters (CVCs) are placed in operating rooms worldwide via different approaches. Like any other medical procedure, CVC placement can cause a variety of complications. We report the case of an unexpected malposition of a catheter in the right internal jugular vein, where it looped back on itself during placement and went upward into the right internal jugular vein. CVC line placement should always be viewed as a procedure that could become complicated, even in the hands of the most experienced operators...
2018: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/29602758/new-method-for-ultrasound-guided-inferior-vena-cava-filter-placement
#11
Xiaojuan Qin, Chengfa Lu, Pingping Ren, Jin Gu, Yi Zheng, Chen Yu, Jian Wang, Mingxing Xie
OBJECTIVE: Transabdominal ultrasound (TAUS)-guided inferior vena cava filter (IVCF) placement currently uses an inferior vena cava (IVC) longitudinal plane with cross-section of the right renal artery or the transverse plane of the right renal vein (RRV)-IVC intersection. The goal of this study was to introduce a new method for TAUS-guided IVCF placement. METHODS: The study enrolled patients who were at high risk for or had pulmonary embolism from October 22, 2010, to June 30, 2016...
March 27, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29582149/obtaining-central-access-in-challenging-pediatric-patients
#12
Cory N Criss, Jake Claflin, Matthew W Ralls, Samir K Gadepalli, Marcus D Jarboe
PURPOSE: Central catheter placement is one of the most commonly performed procedures by pediatric surgeons. Here, we present a case series of patients where central access was obtained at our institution with the utilization of a novel ultrasound-guided technique. This series represents the first of its kind where the native, parent vessels were inaccessible, resulting in a challenging situation for providers. METHODS: A retrospective chart review was performed in pediatric patients (0-17 years) at a tertiary care institution between July 2012 and November 2017 on all central line procedures where ultrasound was utilized to cannulate the brachiocephalic or superior vena cava in face of proximal occlusion...
May 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29573523/presenting-predictors-and-temporal-trends-of-treatment-related-outcomes-in-diabetic-ketoacidosis
#13
Christopher M Horvat, Heba M Ismail, Alicia K Au, Luigi Garibaldi, Nalyn Siripong, Sajel Kantawala, Rajesh K Aneja, Diane S Hupp, Patrick M Kochanek, Robert S B Clark
OBJECTIVE: This study examines temporal trends in treatment-related outcomes surrounding a diabetic ketoacidosis (DKA) performance improvement intervention consisting of mandated intensive care unit admission and implementation of a standardized management pathway, and identifies physical and biochemical characteristics associated with outcomes in this population. METHODS: A retrospective cohort of 1,225 children with DKA were identified in the electronic health record by International Classification of Diseases codes and a minimum pH less than 7...
March 24, 2018: Pediatric Diabetes
https://www.readbyqxmd.com/read/29571658/cryopreservation-of-testicular-tissue-in-pre-pubertal-and-adolescent-boys-at-risk-for-infertility-a-low-risk-procedure
#14
Jessica M Ming, Michael E Chua, Roberto Iglesias Lopes, Anne Marie Maloney, Abha A Gupta, Armando J Lorenzo
INTRODUCTION: Cryopreservation of testicular tissue (TT) has become an increasingly attractive option for fertility preservation (FP), particularly for pre-pubertal boys at risk for gonadotoxicity from cancer therapy. At our institution, all at-risk families undergo counseling regarding infertility risk and available FP strategies, including this vulnerable patient population. As the technology required to use the acquired tissue is, as yet, unproven, it is paramount to document minimal morbidity and complications from this procedure...
March 9, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29552521/video-assisted-right-mini-thoracotomy-for-aortic-valve-replacement
#15
Carl A Johnson, Amber L Melvin, Brandon F Lebow, Amanda Yap, Peter A Knight
Aortic valve replacement through minimally invasive access is increasing. These procedures have several advantages over conventional sternotomy including decreased intensive care unit and hospital length of stay and decreased ventilation time. The right anterior mini-thoracotomy (RAM) approach is potentially attractive in that it completely spares the sternum leading to improved cosmesis, reduced blood loss, and improved patient satisfaction. However, this approach is underutilized due to anticipated technical challenges including difficulty with visualization and annular suture placement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29546772/peripherally-inserted-central-catheters-in-the-treatment-of-children-with-cancer-results-of-a-multicenter-study
#16
Maxim Yu Rykov, Sergei V Zaborovskij, Alexander N Shvecov, Vladimir V Shukin
PURPOSE: To review our experience with peripherally inserted central catheters in pediatric cancer patients. METHODS: The analysis included 353 patients (3 months up to 17 years, mean age 11.2 years) with a variety of cancers diseases, which in 2011-2016, 354 peripherally inserted central catheters were placed. All settings are carried out using ultrasound guidance. In 138 (39%) patients, external anatomical landmarks were used and in 216 (61%) intraoperative fluoroscopy...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29542366/placement-issues-of-hemodialysis-catheters-with-pre-existing-central-lines-and-catheters
#17
Afsha Aurshina, Anil Hingorani, Ahmad Alsheekh, Pavel Kibrik, Natalie Marks, Enrico Ascher
OBJECTIVE: It has been a widely accepted practice that a previous placed pacemaker, automatic implantable cardioverter defibrillators, or central line can be a contraindication to placing a hemodialysis catheter in the ipsilateral jugular vein. Fear of dislodging pacing wires, tunneling close to the battery site or causing venous obstruction has been a concern for surgeons and interventionalists alike. We suggest that this phobia may be unfounded. METHODS: A retrospective review was conducted of patients in whom hemodialysis catheters were placed over a period of 10 years...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29541565/right-site-wrong-route-cannulating-the-left-internal-jugular-vein
#18
Peter Paik, Sanjay K Arukala, Anupam A Sule
Central venous catheters are placed in approximately five million patients annually in the US. The preferred site of insertion is one with fewer risks and easier access. Although the right internal jugular vein is preferred, on occasion, the left internal jugular may have to be accessed. A patient was admitted for septic shock, cerebrovascular accident, and non-ST-segment elevation myocardial infarction. A central venous line was needed for antibiotic and vasopressor administration. Due to trauma from a fall to the right side and previously failed catheterization attempts at the left subclavian and femoral veins, the left internal jugular vein was accessed...
January 9, 2018: Curēus
https://www.readbyqxmd.com/read/29527816/commissioning-of-a-dedicated-commercial-co-60-total-body-irradiation-unit
#19
Jay Burmeister, Adrian Nalichowski, Michael Snyder, Robert Halford, Geoff Baran, Brian Loughery, Ahmad Hammoud, Joe Rakowski, Todd Bossenberger
We describe the commissioning of the first dedicated commercial total body irradiation (TBI) unit in clinical operation. The Best Theratronics GammaBeam 500 is a Co-60 teletherapy unit with extended field size and imaging capabilities. Radiation safety, mechanical and imaging systems, and radiation output are characterized. Beam data collection, calibration, and external dosimetric validation are described. All radiation safety and mechanical tests satisfied relevant requirements and measured dose distributions meet recommendations of American Association of Physicists in Medicine (AAPM) Report #17...
March 11, 2018: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29525366/comparison-of-complications-in-midlines-versus-central-venous-catheters-are-midlines-safer-than-central-venous-lines
#20
Ammara Mushtaq, Bhagyashri Navalkele, Maninder Kaur, Amar Krishna, Aleena Saleem, Natasha Rana, Sonia Gera, Suganya Chandramohan, Malini Surapaneni, Teena Chopra
BACKGROUND: With the rising use of midline catheters (MCs), validation of their safety is essential. Our study aimed to evaluate the incidence of bloodstream infections (BSIs) and other complications related to the use of MCs and central venous catheters (CVCs). METHODS: A retrospective cohort study was performed at a tertiary care hospital in Detroit, Michigan, from March-September 2016. Adult patients with either MC or CVC were included. Outcomes assessed were catheter-related BSI (CRBSI), mechanical complications, hospital length of stay, readmission within 90 days of discharge (RA), and mortality...
March 7, 2018: American Journal of Infection Control
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