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https://www.readbyqxmd.com/read/29439080/risk-factors-for-difficult-peripheral-venous-cannulation-in-hospitalised-patients-protocol-for-a-multicentre-case-control-study-in-48-units-of-eight-public-hospitals-in-spain
#1
Miguel Angel Rodriguez-Calero, Ismael Fernandez-Fernandez, Luis Javier Molero-Ballester, Catalina Matamalas-Massanet, Luis Moreno-Mejias, Joan Ernest de Pedro-Gomez, Ian Blanco-Mavillard, Jose Miguel Morales-Asencio
INTRODUCTION: Patients with difficult venous access experience undesirable effects during healthcare, such as delayed diagnosis and initiation of treatment, stress and pain related to the technique and reduced satisfaction. This study aims to identify risk factors with which to model the appearance of difficulty in achieving peripheral venous puncture in hospital treatment. METHODS AND ANALYSIS: Case-control study. We will include adult patients requiring peripheral venous cannulation in eight public hospitals, excluding those in emergency situations and women in childbirth or during puerperium...
February 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29396996/intranasal-ketamine-and-its-potential-role-in-cancer-related-pain
#2
Vinita Singh, Theresa W Gillespie, R Donald Harvey
Cancer-related pain continues to be a significant therapeutic challenge, made more difficult by contemporary opioid use and diversion concerns. Conventional treatment utilizing a tiered approach of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and adjuvant agents is limited; and alternatives are needed for patients with rapidly progressing pain and those who develop hyperalgesia and tolerance to opioids. Ketamine, an N-methyl-D-aspartate (NMDA) selective antagonist, has historically been used for anesthesia in adult and pediatric populations, but has also been investigated for depression, bipolar disorder, and general and post-operative pain management...
February 3, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29385869/the-use-of-ultrasound-as-an-adjunct-to-peripheral-venous-cannulation-by-junior-doctors-in-clinical-practice
#3
Ryan Breslin, Karen Collins, Jason Cupitt
PURPOSE: There is little consensus on the role of training in bedside ultrasound skills for medical students or junior doctors early in their careers. METHODS: We trained 20 Foundation Year 1 doctors in the use of ultrasound as an adjunct to peripheral venous cannulation and following an assessment of competence gave them access to an ultrasound machine to assist with difficult cannulations in their clinical practice. Self-reported confidence and competence were assessed using pre- and post-training questionnaires, with competence objectively assessed immediately post-training and at one and three months follow up...
January 31, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29377971/patterns-and-predictors-of-short-term-peripherally-inserted-central-catheter-use-a-multicenter-prospective-cohort-study
#4
David Paje, Anna Conlon, Scott Kaatz, Lakshmi Swaminathan, Tanya Boldenow, Steven J Bernstein, Scott A Flanders, Vineet Chopra
BACKGROUND: The guidelines for peripherally inserted central catheters (PICCs) recommend avoiding insertion if the anticipated duration of use is =5 days. However, short-term PICC use is common in hospitals. We sought to identify patient, provider, and device characteristics and the clinical outcomes associated with short-term PICCs. METHODS: Between January 2014 and June 2016, trained abstractors at 52 Michigan Hospital Medicine Safety (HMS) Consortium sites collected data from medical records of adults that received PICCs during hospitalization...
February 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29238233/an-in-vivo-comparison-of-the-efficacy-of-hemostatic-powders-using-two-porcine-bleeding-models
#5
Melinda H MacDonald, Allen Y Wang, Jeffrey W Clymer, Richard W Hutchinson, Richard Kocharian
Background: Usage of topical hemostatic agents in surgery is increasing, including use during minimally invasive procedures, and even for surgeries that have a low risk of bleeding complications. A novel product, Surgicel® Powder - Absorbable Hemostatic Powder (SP), made from oxidized regenerated cellulose (ORC) fabric, has been developed for adjunctive use in surgical procedures to assist in control of oozing bleeding over broad areas and where access could be difficult with a fabric ORC product...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/29200325/incidence-and-risk-factors-of-bacterial-and-fungal-infection-during-induction-chemotherapy-for-high-risk-neuroblastoma
#6
Sarah B Whittle, Kaitlin C Williamson, Heidi V Russell
High-risk neuroblastoma is an aggressive childhood cancer with poor outcomes. Treatment begins with an induction phase comprised of intense multi-agent chemotherapy with the goal of maximally reducing tumor bulk. Given the high intensity of induction chemotherapy, neutropenic fever and infectious complications are common; however, the actual incidence is difficult to determine from clinical trial reports. We performed a retrospective review of infection-related complications in 76 children treated for high-risk neuroblastoma at Texas Children's Hospital...
December 4, 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/29198897/the-idle-central-venous-catheter-in-the-nicu-when-should-it-be-removed
#7
Cristen N Litz, Jordan G Tropf, Paul D Danielson, Nicole M Chandler
PURPOSE: There is debate regarding the optimal timing of central line removal in the neonatal intensive care unit (NICU). The purpose was to evaluate outcomes of idle peripherally inserted central catheters (PICCs) and tunneled central venous catheters (TCVCs) and determine the incidence of line-related infections and replacements. METHODS: Patients in the NICU with T-CVCs placed between 11/2008 and 8/2015 (n=134) or PICCs placed between 7/2013 and 10/2015 (n=467) were included...
November 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29187109/modified-in-situ-pericardial-rerouting-technique-for-scimitar-syndrome-repair
#8
Ignacio Lugones, María Fernanda Biancolini, Victoria Eugenia Zerpa Pacheco, Inés Ana Martínez, Jesús María Maximiliano Damsky Barbosa, Ana María Susana de Dios
Scimitar syndrome repair represents a challenge due to the high incidence of postoperative pulmonary venous obstruction associated with classic surgical strategies. In situ pericardial rerouting technique has been considered a promising alternative approach due to its simplicity and excellent midterm results. Access to the left atrium can be difficult in young patients with severe dextrocardia and hypoplastic right lung. We describe a modification of the original rerouting technique in which the atrial septum is repositioned in order to create a wide opening in the lateral aspect of the left atrium and ensure an adequate size of the reconstructed pathway...
November 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29176933/a-clinical-pathway-for-the-management-of-difficult-venous-access
#9
Vanno Sou, Craig McManus, Nicholas Mifflin, Steven A Frost, Julie Ale, Evan Alexandrou
Background: Many patients are admitted to hospital with non-visible or palpable veins, often resulting in multiple painful attempts at cannulation, anxiety and catheter failure. We developed a difficult intravenous pathway at our institution to reduce the burden of difficult access for patients by increasing first attempt success with ultrasound guidance. The emphasis was to provide a solution for hospitalised patients after business hours by training the after-hours clinical support team in ultrasound guided cannulation...
2017: BMC Nursing
https://www.readbyqxmd.com/read/29152470/fluoroscopy-guided-combined-surgical-endovascular-treatment-of-dural-arteriovenous-fistula
#10
So Hee Park, Jong-Hoon Kim, Chul-Hoon Chang, Young-Jin Jung
For dural arteriovenous fistula (DAVF), when the usual endovascular or neurosurgical approaches are difficult to treat, multi-modal treatment can be helpful. We present a case of a 71-year-old woman with DAVF, who presented with an intracerebral haemorrhage. Digital subtraction angiography revealed a DAVF of the transverse sinus, with cortical venous reflux. Transvenous and transarterial approaches for coil embolization failed. In the operating room, a small craniotomy was performed, and coil embolization was done under fluoroscopy...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29118844/ultrasound-probe-grip-the-afternoon-tea-technique
#11
Luke McMenamin, Stephen Wolstenhulme, Max Hunt, Stuart Nuttall, Asoka Weerasinghe
Background: Globally, ultrasound is being used to assist in central venous and difficult peripheral intravenous access in a variety of emergency and non-emergency clinical settings. Context: After reading Flood's paper on safe central venous access and noting the difficulties clinicians find in probe stabilisation whilst performing dynamic intravenous access, we decided to share our teaching technique. Innovation: The purpose of this correspondence is to highlight the 'afternoon tea technique' as a potential teaching method for probe stabilisation...
August 2017: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29112475/transjugular-venous-approach-for-endovascular-interventions-in-hemodialysis-grafts-and-fistulas-of-the-upper-extremities
#12
Hector Ferral, Marc J Alonzo
OBJECTIVE: This article describes the use of a transjugular venous access for interventions in upper extremity hemodialysis arteriovenous fistulas (AVFs) and grafts. This access is used in selected patients in whom direct puncture of the hemodialysis access is considered to be difficult or cumbersome. Technical success was achieved in 96.7% of patients. If an intervention is unsuccessful, the transjugular access offers the possibility of placement of a dialysis catheter for temporary or long-term hemodialysis...
November 7, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29079071/occult-spinal-cord-injury-after-blunt-force-trauma-in-a-patient-with-achondroplasia-a-case-report-and-review-of-trauma-management-strategy
#13
Martin Huecker, Zach Harris, Eric Yazel
BACKGROUND: Achondroplastic dwarfism is associated with anatomic abnormalities that can predispose to occult injury and challenges in trauma management. Airway anatomy is problematic due to macrocephaly, midface hypoplasia, and a narrow nasopharynx. Manipulation of the neck is very dangerous due to the high likelihood of preexisting cervicomedullary stenosis. Restrictive lung disease and obstructive sleep apnea may complicate respiratory status. Peripheral and central venous access can be difficult to obtain...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29057442/-subcutaneous-implantable-cardioverter-defibrillator-in-prevention-of-sudden-cardiac-death-in-poland-opinion-paper-endorsed-by-the-polish-cardiac-society-working-group-on-heart-rhythm
#14
Paweł Ptaszyński, Marcin Grabowski, Oskar Kowalski, Maciej Kempa, Przemysław Mitkowski, Andrzej Przybylski, Maciej Sterliński
In the past years, cardiovascular mortality has decreased but despite these cardiovascular diseases are responsible for millions of deaths every year in the world and approximately 25% of which are sudden cardiac death (SCD). Implantable defibrillators (ICD) is proven therapy used in primary and secondary SCD prevention. Currently majority of devices use transvenous leads inserted predominantly into the right heart for both pacing and defibrillation. On the other hand, ICD may cause complica-tions, including inappropriate shocks, device-related infection and lead failure...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29034015/a-new-technique-for-femoral-venous-access-in-infants-using-arterial-injection-venous-return-guidance
#15
Hironori Ebishima, Masataka Kitano, Kenichi Kurosaki, Isao Shiraishi
Objectives: Although venography guidance is helpful for central venous catheter placement, it is sometimes difficult to place a peripheral intravenous cannula for enhancement. We designed a new technique for establishing femoral venous access using venography guidance in the return phase of peripheral arteriography. This new technique was named arterial injection venous return guidance. Here we assessed the efficacy and safety of arterial injection venous return guidance. Methods: We reviewed data of 29 infants less than 6 months old undergoing catheter intervention at our institute in 2014...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28983903/dynamic-ultrasound-guided-short-axis-needle-tip-navigation-technique-vs-landmark-technique-for-difficult-saphenous-vein-access-in-children-a-randomised-study
#16
S Hanada, M T Van Winkle, S Subramani, K Ueda
Dynamic ultrasound-guided short-axis needle tip navigation is a novel technique for vascular access. After venipuncture, the needle and catheter are further advanced within the vessel lumen under real-time ultrasound guidance with constant visualisation of the needle tip in the short-axis view. This can minimise the risk of transfixing the cannulated vessel. We compared two techniques for non-visible saphenous vein cannulation under general anaesthesia in children weighing ≥ 3 kg and less than four years of age: dynamic ultrasound-guided short-axis needle tip navigation technique (ultrasound group) vs...
October 6, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28912977/isolated-persistent-left-superior-vena-cava-sick-sinus-syndrome-and-challenging-pacemaker-implantation
#17
Hatice S Kemal, Aziz Gunsel, Levent Cerit, Murat Kocaoglu, Hamza Duygu
Persistent left superior vena cava with absent right superior vena cava is a very rare venous anomaly and is known as isolated PLSVC. It is usually an asymptomatic anomaly and is mostly detected during difficult central venous access or pacemaker implantation, though it could also be associated with an increased incidence of congenital heart disease, arrhythmias, and conduction disturbances. Herein, we describe a dual-chamber pacemaker implantation in a patient with isolated PLSVC and sick sinus syndrome.
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28904485/temporary-left-ventricular-pacing-a-desperate-life-saving-measure-in-emergency-situation
#18
Ajaz Ahamad Lone, Mohd Iqbal Dar, Fayaz Ahamad Rather, Mohd Sultan Alai, Imran Hafiz, Jahangir Rashid Beigh
Transcutaneous or transvenous pacing of the right ventricle is performed as a routine practice for patients received with symptomatic bradycardia or complete heart block with relative ease in cath lab. However, more and more patients are received with multiple comorbidities, critical condition, and difficult vascular access. In this article, we describe a patient with difficult venous access with tricuspid regurgitation and displaced the right ventricular pacemaker temporary lead undergoing coronary angiography who was managed with emergent nonconventional left ventricular pacing...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28893316/intraosseous-blood-samples-for-point-of-care-analysis-agreement-between-intraosseous-and-arterial-analyses
#19
Milla Jousi, Simo Saikko, Jouni Nurmi
BACKGROUND: Point-of-care (POC) testing is highly useful when treating critically ill patients. In case of difficult vascular access, the intraosseous (IO) route is commonly used, and blood is aspirated to confirm the correct position of the IO-needle. Thus, IO blood samples could be easily accessed for POC analyses in emergency situations. The aim of this study was to determine whether IO values agree sufficiently with arterial values to be used for clinical decision making. METHODS: Two samples of IO blood were drawn from 31 healthy volunteers and compared with arterial samples...
September 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28875044/decreased-rivaroxaban-levels-in-a-patient-with-cerebral-vein-thrombosis-receiving-phenytoin
#20
Ana F Becerra, Tomas Amuchastegui, Aldo H Tabares
Combined use of antiepileptic drugs and anticoagulants is common. We describe the first case documenting laboratory interaction between rivaroxaban and phenytoin. A 48-year-old woman was admitted to our hospital due to cerebral venous thrombosis, bilateral pulmonary embolism, and deep vein thrombosis. She came from a small town with difficult access to warfarin monitoring. She was receiving phenytoin 100 mg three times daily (t.i.d.) and started enoxaparin 60 mg twice daily (b.i.d.). An abdominal mass was diagnosed and removed by laparoscopy (gastrointestinal stromal tumor)...
2017: Case Reports in Hematology
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