Approximately 94 million infants are born each year worldwide. All of these infants are vulnerable to cold stress and thus hypothermia, regardless of their gestational age or weight. It is important to provide them with an adequate and stable environment because of...
Which intubation guide to choose for which patient?
Intubation is one of the most common practices for an anaesthetist. However, when this technique is performed, the patient's airways are often not as accessible as we would like. This is why an intubation guide is very often necessary to facilitate intubation into the...
Wireless Ultrasound in the field of Vascular Access
The PERSEUS guidelines, recently released by the European Society of Anaesthesiology and Intensive Care (ESAIC), recommend a global use of ultrasound to assist all steps of central venous catheterization in order to minimize all immediate, early, and late...
Ultrasound in the placement of PICCs and midlines
As the GAVeCeLT group (1) stated in their manual on PICCs and midlines regarding the evolution of PICC use, the introduction of ultrasound in the 2000s has been a breakthrough in the field. In this article, we delve into the utility of ultrasound in the field of...
CSSAS: Closed Safety Systems for Administration to Reduce Risks of Occupational Exposure to HMPs
In this article, we will introduce Closed Safety Systems for Administration (CSSAs) as an important way to differentiate between CSTDs.
Introduction of ECG tip location into practice: A testimonial of Nicola Wyllie
This article discusses the implementation of electrocardiogram tip location (ECG TLS) for the confirmation of central venous catheter tip position. The author works within a nurse led vascular access service in NHS Scotland and has found that this method of catheter...
How is Vascular Access viewed and managed in France ? – An interview with Christian Dupont
Have you ever wondered how nursing works outside of your country? What protocols are used, how is the coordination between professionals, and how is patient follow-up conducted? Christian Dupont is a nurse at one of the major hospital centers in the French capital,...
“Right line at the right time”- a District General Hospitals perspective on the introduction of a nurse led midline service
Acute Cardiac Care Unit, Crosshouse Hospital, NHS Ayrshire & Arran, Scotland Within cardiology, there is a cohort of patients who require prolonged IV access, such as those with decompensated heart failure and those with infective endocarditis. Moreover,...
Everything you need to know about tunnelling in midlines
In ultrasound-guided procedures, it is possible that an ideal vein isn't found in the optimal catheter exit zone. When confronted with the decision between "immediate placement of a line out of necessity for the patient" and "waiting for potential alternatives,"...
Specificities of central venous access in paediatrics
A testimonial of Dr Eric Desruennes There aren't many differences between children over 2 years and adults. On the other hand, newborns, infants, and children under 2 years are quite different due to: - Their small weight and vessels, and sometimes the...
Addressing Pain During Neonatal PICC Placement
In neonatal care, the delicate nature of patients demands meticulous attention to every aspect of their well-being. The placement of a peripherally inserted central catheter (PICC) in neonates, while essential, presents a significant challenge due to the fragile and...
Ensuring optimal care for DIVA patients
The VAD (vascular access device) insertion experience varies between patients. For individuals with difficult intravenous access (DIVA), the process can become traumatic and notably painful. According to Blanco (2019), DIVA affects up to one-third of critically ill...
SIP-2 Protocol: Making PICC Insertions Easier
In modern healthcare, multiple professionals are responsible of inserting vascular access devices in patients. Within the same hospital, different categories of professionals end up using the same type of catheters. However, when each of these professionals employs...
Key good practice points to help prevent totally implanted vascular access device occlusion
One of the most common complications associated with vascular access devices (VAD) is occlusion. Device occlusion can potentially result in treatment being either halted or missed. This can have a negative effect on treatment outcomes. Occlusion can be partial,...
3 tips for proper PICC-port placement
PICC-port is gaining prominence as a primary vascular access device for oncology patients, surpassing traditional chest ports and outdated brachial ports. Dr. Bertoglio's recently published multicentre study, which examined over 4000 PICC-ports, demonstrates the...
What are the advantages of PICC-port?
PICC-port is an implanted catheter that is undoubtedly gaining ground in the world of vascular access. Its growing success is not surprising: it comes with new indications, cost reduction and patient satisfaction. Even if PICC-port has been in use for several decades,...
5 key advantages of midlines you should know of
Short Peripheral Intravenous Catheters (SPIVCs) are commonly used as default vascular access devices by practicians around the world for short and midterm therapies. However, they can be a problem in case of medium therapies as that would entail the insertion of...
Overview of anatomy and physiology related to vascular access: veins of the chest and neck
This article about chest and neck veins is part of a series about the anatomy and physiology related to vascular access. To read the first part about arm veins, click here. Chest and neck veins are often used for the insertion of acute central venous catheters (CVCs),...
6 measures to ensure the proper functioning of a PICC-port
Healthcare professionals working with oncology patients are used to handling fully implanted catheters. In recent years, PICC-port has proven to be very useful in the field. However, any vascular access device can become a problem if its placement has not been optimal...
Overview of anatomy and physiology related to vascular access: peripheral veins
VADs (Vascular Access Devices) can be inserted in various areas of the body via a selection of veins. Some venous access sites can result in more complications. It is therefore important to carefully select the vein for access. The purpose of this article is to detail...
Catheter to vein ratio: What are the recommendations?
With the introduction of venous mapping methods prior to the placement of a central venous catheter (RaPeVA, RaCeVA, and RaFeVA), the evolution of ultrasound techniques has given a fundamental role to the choice of vein. In fact, the measurement of this vein (obtained...
Extravasation: Causes and treatment
Extravasation can be defined as the accidental leakage of a chemotherapy infusion into the subcutaneous tissues, and exceptionally into the pleura or mediastinum. It can be an absolute therapeutic emergency depending on the product that was used. Of all the possible...
Implantable ports: Causes of dysfunction you should know about
Dysfunction with implantable ports is characterized by an absence of blood reflux. It can be associated to a decrease or loss of perfusion flow. Its incidence is of 0.6 to 2.5 per 1000 days/catheter. Causes are multiple. Etiologic diagnosis is essential because each...
Central venous catheters dysfunctions: diagnosis, causes and treatment
Central venous catheters are intravenous devices whose distal end must be located at the atrio cava junction (union of superior vena cava and right atrium). They allow the infusion of irritant drugs, with a pH < 5 or > 9 or hyperosmolar > 600 mosm/l, in...
Skin lesions in Vascular Access: Management and Prevention
Skin lesions include MARSIs and various intrinsic or clinical conditions that pose a challenge in maintaining adequate fixation of the central catheter on the patient’s skin…