In acute care areas, where patients can be hemodynamically unstable (or at risk of instability), clinicians aim to optimize perfusion in order to avoid organ dysfunction, multi-organ failure, or even death. These areas refer to critical care units, perioperative areas...
6 Keys to proper care and maintenance of the CVC
Central venous catheters are one of the most commonly used devices in hospitals, however, they can present some complications, and to avoid them, proper care and maintenance of the device is essential. WHAT WILL YOU FIND IN THIS ARTICLE? Monitoring of the insertion...
10 Keys to safe internal jugular vein CVC placement in pediatrics
According to studies, the success rate of IJV cannulation in infants can be 100% as long as certain measures are taken and catheter insertion is ultrasound-guided. 1 WHAT CAN YOU FIND IN THIS ARTICLE? Pediatric patients: the challenges of central venous cannulation...
Volume response in septic shock. Case study presented by Dr. Sergi Tormo Ferrándiz
Sepsis is defined as a systemic inflammatory response to infection. This scenario is encountered daily in all healthcare centres with a rate of 10 per 1,000 hospitalised patients. This condition is of great importance as mortality is observed in 20% of sepsis...
Fluid therapy: challenges in the septic patient
The administration of fluids is essential for the survival of the critical patient in shock, regardless of the cause of the shock. This supply occurs to a greater extent during the first hours and days of stay, since it is during these that resuscitation of the...
5 key parameters to understand the hemodynamic response of a septic patient
The first definition of sepsis was made in 1980 and was based on the concept of Systemic Inflammatory Response (SIRS). Despite advances and new definitions over the years, it was then that the basis for the management of the septic patient was established. Sepsis is...
Seldinger technique: when to use the classical or modified method
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. In fact, initially known for the insertion of arterial 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...
5 midline complications to know
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. Scientific evidence shows us that this class of...
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,"...
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...
Facilitating cannulation in neonates: Microseldinger technique
Neonatal patients admitted to Intensive Care Units are subjected to continuous manipulations and invasive procedures. One of the main objectives of nursing care is to minimize the practice of aggressive techniques in order to improve care and prevent complications....
Combining aesthetics and feasibility in chest port placement
Recommendations of Dr Diane Weber Two years ago, I met Alicia, a breast cancer patient. After struggling with the disease for a while, she had to undergo a mastectomy. Soon after her surgery, a need for a chest port was identified. She came to me asking for an...
What care should be given to the newborn during the Golden Minute?
At birth, neonates initiate physiological processes that facilitate their adaptation from the intrauterine environment to the extrauterine environment. This adaptation is sometimes complex due to the innumerable responses - chemical, neurological, sensory, thermal and...
3 keys to choosing the best hemodynamic monitor for our patients
Hemodynamic monitoring provides us with information on cardiovascular performance and has therefore become a fundamental tool in the diagnostic approach and therapeutic orientation. More and more devices are becoming available that allow us to carry out advanced...
CSSAS: Closed Safety Systems for Administration to Reduce Risks of Occupational Exposure to HMPs
Healthcare professionals handling chemotherapy for preparation and administration of HMPs are likely to be exposed to potential contamination risks associated with cytotoxic drugs. These risks can lead to health implications, ranging from minor issues like headaches,...
Enteral nutrition in the newborn: analysis of scientific evidence on feeding methods
The following article offers an in-depth analysis of the scientific evidence on enteral nutrition in infants, focusing in particular on the methods of administration. Nutrition in infants is a vital component for their development and well-being, and the choice of the...
Enteral nutrition in infants: the problem of accidental connections
For the treatment of patients, from adults to infants and premature babies, admitted to health care facilities, it is often necessary to place probes and catheters, the use of which involves the administration of enteral nutrition in addition to the infusion of drugs...
Enteral nutrition in infants: small connections for small patients
For the treatment of patients, from adults to infants and premature babies, admitted to healthcare facilities, it is often necessary to place probes and catheters whose use includes the administration of enteral nutrition in addition to the infusion of drugs and other...
Efficacy and importance of connector cleaning in neonatal enteral nutrition
Enteral nutrition tubes are used in healthcare facilities to administer nutrition, fluids and medication to patients who cannot be fed orally. For years, these patients have been subjected to the risks of misconnections, defined as incorrect administration of an...
5 things to know about thrombosis in PICCs
In this article, we will address thrombosis in peripherally inserted central catheters (PICCs) based on the following aspects: incidence, causes, physiology, symptomatology, and prevention. What is thrombosis? Thrombosis is the formation of a clot in a vessel. It can...
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...
The PICC-port revolution
The PICC-port is the latest breakthrough in Venous Access Devices (VADs) and is now included in the DavExpert app's solution for patients. New studies are showing it is a safe, effective, efficient and goodlooking option for cancer patients. How has this device...
Recommendations for the management of difficult airways during COVID-19
As some of the commonly recommended strategies for managing difficult airways are not optimal in the context of COVID-19, the Society for Airway Management (SAM) decided to take action. To this end, it has set up a task force to review existing literature and current...
Enteral nutrition delivery systems: which one to choose in neonates?
Nutritional needs are understood as the amount of each of the nutrients required by an individual at each stage of life to maintain a correct nutritional status and, thus, prevent disease and ensure proper growth. Ensuring that these nutritional needs are met in the...
Midline catheter: placement and maintenance protocol
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. Midline catheters must be placed by trained and specialised...
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,...
The importance of surfactant in the neonatal patient
Pulmonary surfactants along with other therapeutic measures are the treatment of choice for various respiratory conditions. A surfactant deficiency in preterm infants leads to respiratory distress syndrome characterized by poor lung expansion, inadequate gas exchange...
Is the use of cleaning protocols sufficient to increase the safety of ENFit® connectors in neonates?
The introduction of ENFit® connectors in neonatology units, with the aim of avoiding connection errors between systems intended for different clinical therapies, has generated much debate among experts in the field. The new connector for enteral nutrition poses a...
Hypothermia in newborns, how to prevent it?
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...
How to locate the tip of a PICC
The reference guidelines on vascular access leave no doubt: it is essential to position and correctly locate the tip of a PICC. Otherwise, healthcare professionals risk encountering complications that can jeopardize the ongoing treatment and even the patient's health....
ZIM method and tunnelling in PICC placement
In Intravenous Therapy Teams, PICC placement using standard MST (Modified Seldinger Technique) is common practice and generally well controlled. However, complications can arise if the standard technique is applied, and the insertion site is unsuitable. Failure to...
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...
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...
PICC placement in patients with Atrial Fibrillation
According to the studies by Dr Pittiruti and Dr LaGreca Since the late 1980s, Dr Pittiruti and Dr LaGreca of the Fondazione Policlinico Universitario Agostino Gemelli in Rome have been researching the possibility of using ECG to locate the tip of a PICC. In 1989 (1),...