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...
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 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 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…
Introduction Vascular access is the commonest invasive procedure performed on hospitalised patients, but it is not without complications1. Complications can include phlebitis, localised infection, blood stream infection, thrombus, infiltration and extravasation, and...
Ever since their creation, vascular access teams dedicated to PICC placement have proven to be efficient in reducing catheter-related complications. However, as Nancy Moureau commented in a clinical case on thrombosis in 2016, there are still complications that can...
Introduction The aim of this article is to describe and discuss some differences between the short peripheral intravenous catheter (SPIVC) and the long peripheral intravenous catheter (LPIVC) inserted using the Seldinger Technique. It will consider how these...
On medical devices labels, manufacturers have to include the necessary information about the equipment that healthcare professionals are going to use for patient care. Provided on products’ batches or packaging, labels are an essential tool to identify the product and...
The mechanical complications of an implantable port are numerous and frequent. However, they are often avoidable if the basic rules of insertion and use are known and respected. We can classify the causes of mechanical complications of ports as follows: - Catheter...
Intravenous therapy is a usual treatment for hospitalized patients and increasingly, for those who are at home. The administration of drugs can give rise to problems such as phlebitis and extravasation among others, which can force us to use various peripheral routes. Over time, different devices have emerged, including midlines…
The last article in this series discussed methods to reduce the risk of complications in PICCs. This final article will focus on how to troubleshoot some of the most common complications associated with PICCs if they do occur…
In this article, we interview Marta Rubio de las Cuevas on the placement of PICC-ports by multidisciplinary teams. Marta has been a nurse in the Vascular-Interventional Radiology Department at the Marqués de Valdecilla University Hospital in Santander, which has been a pioneer in the training of multidisciplinary teams for the insertion of PICCs for 43 years…
In this article, we will address thrombosis in peripherally inserted central catheters (PICCs) based on the following aspects: incidence, causes, physiology, symptomatology, and prevention…
The use of PICCs has increased in recent years and can now be found in many specialties and in both hospital and out of hospital settings. Despite being devices that are beneficial to patient care, they are associated with potential complications. Such complications include: infection, occlusion, thrombosis, catheter, migration, catheter fracture…
We are currently seeing a boom in therapeutic apheresis (TA) with indications not only in oncohaematology, but also in nephrology, cardiology, dermatology, gastroenterology, rheumatology, neurology, metabolic diseases… the list of diseases whose treatments include TA goes on and on…
Too many patients attend the Oncology Day Hospital (ODH) services to receive their chemotherapy treatment. In an environment with a significant healthcare burden, nurses are also exposed to the danger of cytostatic drugs used in cancer treatments…
The evolution of the Seldinger technique since its development in the 1950s has allowed this method to be used with other types of vascular access devices and in fields outside of interventional radiology…
Although Vascular Access Devices (VAD) have many advantages, the burden of harm associated with them is significant. It is now accepted that the presence of any VAD immediately places patients at risk of complications…
The midline catheter growth has been exponential since it is a resource that allows a notable improvement in the management of vascular access for medium-term treatments compatible with peripheral perfusion…
The performance of a Vascular Access Device (VAD) can be predicted based on four criteria: tip position, insertion technique, cannulated vein and exit site.
The increasing use of infusion pumps for chemotherapy treatments means that they must be used with hazardous drugs (e.g. 5-fluorouracil), which poses a risk of exposure for workers, patients and caregivers during the filling, handling, administration and removal of this type of device.
The clinical study on breast cancer patients has reported a very low incidence of PICC-port failure (2.6%), similar to the figures reported for chest-ports. Therefore, PICC-ports are safe, and their use is recommended when chest ports are not an option.
Maintenance of PICCs requires a set of washing and sealing procedures. However, what should be done if a PICC catheter is obstructed despite applying the protocols correctly?
The subclavian vein puncture, area of the axillary-subclavian junction, is known for its possible complications such as pinch-off syndrome and pneumothorax. These are perfectly avoidable when the puncture is performed under ultrasound monitoring.
In this article, we will see what the impact of elderly patients is on hospitals and how peripheral vascular access can be managed when such patients require intravenous treatment.