Easy | Reliable | Accessible In the evolving environment of perioperative care, clinicians depend on haemodynamic monitoring systems that not only deliver reliable data but also integrate seamlessly into workflows. For anaesthetists, ODPs, and critical‑care teams,...
Securing vascular access is a routine but critical step in patient care. For many, it’s straightforward. For others, it can become a source of anxiety, repeated attempts, delays in treatment and, ultimately, poorer outcomes. These patients fall into a group widely...
Why Precision, Safety, and Clinical Understanding Matter More Than Ever Caring for neonates, especially preterm or critically ill infants, requires a level of precision unmatched in any other patient population. Their nutritional needs are unique, their physiology is...
Necrotising enterocolitis (NEC) is one of the most devastating gastrointestinal emergencies in neonatal care, predominantly affecting preterm and very low‑birth‑weight infants. Its prevalence can reach 11% in VLBW infants and 22% in ELBW infants, with mortality...
Precision Feeding and Medication Delivery in the Smallest and Sickest Patients In neonatal care, the difference between 0.1 mL and 0.2 mL is not trivial, it can be life‑changing.Neonates, especially extremely low‑birth‑weight infants (ELBW), receive both nutrition and...
Distinguishing Normal Immaturity from Early Warning Signs Feed tolerance assessment is one of the most critical daily responsibilities in neonatal care. Preterm infants have immature gastrointestinal systems, making it challenging to distinguish normal adaptation from...
Supporting Safe, Developmentally‑Appropriate Oral Feeding in Preterm Infants For preterm and medically complex infants, transitioning from tube feeding to oral feeding is a highly individualised developmental journey. Enteral Feeding Guidelines emphasise a cue‑based,...
Total Intravenous Anaesthesia (TIVA) relies on precise drug delivery through infusion lines. While the focus often lies on pharmacology and monitoring, the hardware configuration - specifically the number of lumens in your TIVA set - can significantly impact safety,...
Effective fluid management is a cornerstone of safe anaesthesia, perioperative care, and critical care medicine. Yet, even with decades of clinical experience, determining the right amount of fluid for each patient remains one of the most debated aspects of...
Improving Stability, Reducing Complications, and Streamlining Care Peripherally inserted central catheters (PICCs) are essential for delivering reliable vascular access, but maintaining secure, stable placement throughout the full dwell time can be challenging....
Accurate haemodynamic monitoring is central to safe care in operating theatres, emergency settings, and critical care environments. Cardiac output (CO) monitoring provides essential insight into a patient’s circulatory status, supporting early recognition of...
Midline catheters are designed to provide stable, medium‑term intravenous therapy, typically when treatment is expected to exceed the limits of short peripheral cannulas (3-4 days), where the treatment does not require central venous access. Accurate device selection...
Vascular access is the most common procedure that patients in tertiary care undergo and, with recent improvements and advances in technology, the choices of devices and insertion techniques have evolved. It is therefore important that education and training is...
Understanding the patient’s condition before inserting a medical device is a vital step in ensuring safe and effective care. This involves a thorough assessment to determine suitability and identify any potential risks. Equally important is recognising the factors...
This article is a summary of: “Illuminating the path to better patient outcomes: how ultrasound-guided vascular access is transforming care” by David Wynne, Ian Tydeman, and Sean O’Donnell in Clinical Services Journal, March 2026 p.51-54 Download the Full Article...
Infections related to central venous catheters remain a significant cause of healthcare-associated bacteraemia and septicaemia[1]. Infections from central venous catheters can come with a significant risk of morbidity and mortality. It is important therefore to...
This article provides a comprehensive, data-driven comparison between local-regional anaesthesia and general anaesthesia, demonstrating why local-regional anaesthesia is a superior option for the modern, environmentally conscious clinician. Its goal is to highlight...
The safe and effective insertion of a central venous catheter (CVC) requires a solid understanding of both the theoretical and practical aspects of the procedure. This includes a foundational knowledge of ultrasound physics and the ability to apply ultrasound guidance...
Insertion of central venous lines is becoming more commonly undertaken by specialist nurse-led units[1],[2]. To reduce complications, it is imperative these are only placed by experienced, trained and competent operators[3], [4]. Most guidelines now advise that, in...
Central venous catheter (CVC) insertion carries a risk of complications which clinicians must be prepared to manage. This article outlines common complications, their causes, methods of prevention, and appropriate clinical responses to ensure safe and effective...
Following device insertion, it is critical that the device is managed correctly to prevent post insertion complications. According to Loveday et al (2014)[1] and Moreau et al. (2013)[2] Healthcare workers caring for patients with intravascular catheters should be...
In Neonatal Intensive Care Units (NICUs), vascular access is not optional, it’s essential. Over 85% of NICU patients require some form of Vascular Access (VA) during their stay. Yet, the choice of device and insertion technique can dramatically affect outcomes....
Helping Neonatal Teams Assess Their Preparedness for Less Invasive Surfactant Administration Less Invasive Surfactant Administration, known as LISA, is becoming an increasingly important technique in supporting preterm infants with respiratory distress syndrome. It...
Data suggests that ‘Up to 90% of hospital inpatients require IV therapy’[1]. With the number so high and wide-reaching to patients and clinicians alike, improvements to vascular access presents one of the biggest opportunities to improve practice with the goal of...
This is an example of setting up a Mostcare Up device. Accurate haemodynamic monitoring is fundamental in critical care and choosing a device which gives clinicians access to real‑time, beat‑to‑beat data that can guide timely, lifesaving decisions is crucial to...
Less Invasive Surfactant Administration (LISA) has transformed the respiratory care of preterm infants with respiratory distress syndrome (RDS). It offers a method of delivering life-saving surfactant while avoiding endotracheal intubation and the potential...
The landscape of vascular access is evolving rapidly, driven by new therapies, increasingly complex patient needs, and an ever‑stronger focus on safety and consistency. As clinicians strive to balance therapeutic effectiveness with minimising harm, high‑quality...
Article summary of Ghouri M, Ali I. Reducing hypothermia in high risk infants: ongoing challenges in later preterm and term neonates. Infant. 2025;21(6):160‑3. Neonatal hypothermia remains common due to newborns’ immature thermoregulation and physiological...
Respiratory Distress Syndrome (RDS) remains one of the most common and challenging conditions in preterm infants. Surfactant replacement therapy has been a cornerstone intervention for decades, traditionally delivered via endotracheal intubation followed by mechanical...
In recent years, the conversation around anaesthetic practice has expanded beyond theatre efficiency and clinical outcomes to include a new, urgent dimension: environmental sustainability. As healthcare organisations evaluate their carbon footprint, anaesthesia has...
Why Ease of Use Matters For anaesthesiologists, intensivists, and critical care nurses, time and cognitive bandwidth are limited resources. While traditional vital signs can be slow or nonspecific during early instability, continuous haemodynamic...
The Sixth National Audit Project (NAP6)1 was the largest UK study on perioperative anaphylaxis, reviewing over three million anaesthetics across all NHS hospitals between 2015 and 2016. Its findings were significant: approximately one in 10,000 anaesthetics resulted...
Behind every successful arterial line insertion lies a solid understanding of anatomy and site selection. This is critical to patient safety, procedural success, and long-term outcomes. Long before the needle touches the skin, it is important to carry out a thorough...
The first hour of a premature baby’s life is known as the ‘Golden Hour’. Research shows that what happens in the first hour of a premature baby’s life is the most crucial and can make a difference between a good outcome and a poor outcome or, the worst-case scenario...
Current estimates suggest that in the UK, around 500,000 people are immunocompromised. This number equates to 0.7% of the population [1] who are higher risk for severe outcomes should an infection occur. It is well known that incidences of CLABSIs (Central line...
Longline catheters are commonplace in neonatal and paediatric care, providing reliable access for delivering parenteral nutrition, medications, and fluids over extended periods. Traditionally, these catheters are inserted using direct introducer or peelable cannula...
In our previous article on Longline Catheter Insertion Using the Modified Seldinger Technique (MST): Clinical and Economical Advantages, we explored how the use of MST optimises placement and reduces procedural complications. Now that the longline catheter is...
Safe removal of a longline catheter is a critical step in neonatal care. Improper technique can lead to serious complications, including air embolism, bleeding, infection and, in rare cases, catheter embolus. Neonates are particularly vulnerable due to their small...
Sustainability is becoming a critical priority in healthcare, driven by ambitious targets such as the NHS commitment to achieve Net Zero by 2040 and the EU Green Deal objectives. Medical devices contribute significantly to the healthcare sector’s carbon footprint,...
By Prof. Ehrenfried SCHINDLER PRAM and MostCare are trademarks of Bio-Si International s.r.l. Haemodynamic monitoring is essential in paediatric peri-operative and critical care medicine, guiding adequate tissue perfusion and oxygen delivery in the most...
Intravenous (IV) therapy is a cornerstone of modern medicine, enabling the delivery of fluids, medications, and nutrition directly into the bloodstream. Peripherally Inserted Central Catheters (PICCs) have been the preferred choice for patients requiring medium- to...
When withdrawing a Huber needle from an implantable port, complications such as occlusion can arise. It is one of the leading complications in Central Venous Access Devices (CVADs), affecting up to 1 in 3 catheters1 and can potentially lead to serious or...
Post-operative hypotension is a common and clinically significant challenge, often linked to poor outcomes such as organ dysfunction, prolonged recovery, and increased mortality. Vasopressors are routinely used to manage this condition. Until recently, their use in...
Haemodynamic monitoring and management are fundamental components of perioperative care. Accurate measurement and interpretation of advanced haemodynamic variables can guide clinical decisions and therapeutic interventions, ultimately enhancing patient...
The removal of totally implanted central venous access devices (TVAD), or Ports is associated with the risk of adverse events, among which some are insignificant and others more relevant or serious. The technique of appropriate removal has only been described in a few...
Premature birth frequently results in complications for both infants and their families and so continues to be a pressing topic in global neonatal healthcare. While medical advancements have significantly improved outcomes for many preterm babies, simple yet effective...
Early identification of sepsis is critical for patient survival, yet it remains a significant challenge[1]. Nurses play a vital role in this process by routinely monitoring patients for signs of sepsis. This article highlights key aspects of identification and...
Healthcare faces mounting challenges from climate change and rising operational costs. A significant portion of its carbon footprint stems from plastic waste, and the energy demands of departments such as operating theatres and intensive care units. To mitigate this,...
Finding ways to streamline NICU care while improving the quality of care is essential, especially for these most vulnerable patients. Custom packs promote standardised insertion procedures, ensuring maximum barrier precautions and reduced risk of infection....
Based on a presentation by Dr Keliana O'Mara, PharmD, NICU Pharmacy specialist WakeMed Health and Hospitals, United States In neonatal intensive care units (NICUs), where the tiniest patients rely on technology for survival, precision isn't a luxury, it’s a...
Emergency and critical care teams face a recurring dilemma in early septic shock: How much fluid is enough, and when should we start vasopressors? Prolonged hypotension drives organ injury and mortality, but both fluid overload and delayed vasopressors can harm. The...
Vascular access is crucial in nursing practice. The choice of the appropriate venous access device, such as the Midline or the PICC, and the insertion technique, whether the classic Seldinger technique or the Modified Seldinger, can significantly influence the...
Administering the right amount of fluids is crucial in sepsis and septic shock. In critically ill patients, the goal of intravenous fluid therapy is to increase cardiac output to improve both micro- and macro-circulation and tissue oxygen delivery (DO₂). However, in...
In cardiac surgery, it is commonplace for Anaesthetists to place a sheath introducer, or pulmonary artery catheter, when high volume access is required, along with a standard 4-lumen/quad central venous catheter (CVC) for multi-drug delivery and haemodynamic...
Definition of NEC Necrotising enterocolitis (NEC) is a serious condition that can occur following preterm birth, characterised by bowel inflammation that prevents milk feeding and may require surgery. It is associated with high mortality rates, exceeding 20%. The...
The proportion of patients who have a central venous catheter (CVC) inserted has increased over the years, so much so that 78% of patients admitted to intensive care units (ICU) in Europe have a CVC inserted.7 However, central venous catheter (CVC) placement...
The healthcare landscape is evolving rapidly, and so are the roles of nurses and allied health professionals. One of the most significant shifts in recent years has been the expansion of nursing responsibilities into areas traditionally reserved for physicians—such as...
Understanding the Foundation of Safe Arterial Cannulation Behind every successful arterial line insertion lies a solid understanding of anatomy and site selection. These aren't just academic concepts—they're critical to patient safety, procedural success, and...
Laying the Groundwork for Safe Arterial Line Insertion Before a needle touches the skin, a thorough patient assessment and clear communication are essential. These early steps are not just procedural—they are foundational to patient safety, ethical practice, and...
Executing Arterial Cannulation with Precision and Confidence Arterial line insertion is a high-skill procedure that demands both technical precision and clinical awareness. Whether you're using the direct puncture method or the Seldinger technique, success hinges on...
Staying Ahead of the Risks in Arterial Cannulation While arterial line insertion is a routine procedure in critical care, it is not without risk. Even with proper technique and training, complications can occur—some minor, others potentially life-threatening. The key...
Protecting the Line—and the Patient—After Placement The work doesn't end once the arterial line is in place. In fact, the post-insertion phase is just as critical as the insertion itself. Proper care and maintenance are essential to prevent complications such as...
From delivery to the NICU, hospital to hospital and even unplanned home deliveries, neonatal transport is crucial for making sure babies receive the care they need at the right time, and at a unit suited to their needs. Maintaining normothermia during transport has...
Introduction Intra-operative haemodynamic management is a cornerstone of safe and effective surgical care. The 2025 guidance from the European Society of Anaesthesiology and Intensive Care (ESAIC) provides updated, evidence-informed recommendations for clinicians...
Fluid management is a cornerstone of patient care, particularly in critical conditions like septic shock. However, the line between adequate resuscitation and harmful fluid overload is often thin. Recognising the risks and implementing strategies to prevent fluid...
Advanced Haemodynamic monitoring, particularly the ability to track stroke volume (SV) and cardiac output (CO), has significantly contributed to the refinement of anaesthesiologists’ expertise in Haemodynamic management. Beyond serving as cardiac output monitors,...
One in ten children with a central venous catheter (CVC) develops a device-associated bloodstream infection. 2 Want to know how to prevent bacteremia and central venous catheter-related infection? Dr. Paco Escribà, anaesthesiologist FEA Anaesthesiology for children,...
Sepsis remains a critical threat to children, with septic shock frequently requiring admission to Paediatric Intensive Care Units (PICUs).1 Early and appropriate fluid resuscitation is paramount for improving outcomes and reducing mortality in these vulnerable...
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 characterised by poor lung expansion, inadequate gas...
Overview Healthcare providers play a crucial role in ensuring that patients receive the best care possible, especially when managing complex medical devices like Tunnelled Central Venous Catheters (TCVCs). To support this effort, we are excited to introduce...
In the field of oncology treatment, Totally Implanted Venous Access Devices (TIVADs) have proven to be effective and safe for patients. The choice of placement site for these ports can however significantly impact a patient's body image and overall wellbeing....
Central venous catheters (CVCs) are essential tools in modern medicine, providing reliable vascular access for fluid administration, medication delivery, and haemodynamic monitoring. However, CVC insertion can be a resource intensive procedure with potential for...
Neonatal care often necessitates reliable vascular access for the administration of parenteral nutrition, medications, and other critical therapies. The Modified Seldinger Technique (MST) has emerged as a valuable method for inserting neonatal peripherally inserted...
Introduction Venous catheters are essential medical devices for intravenous (IV) therapy, allowing healthcare professionals to administer medications, fluids, and nutrients directly into a patient's bloodstream. The choice of catheter can significantly impact both...
The thoracic reservoir has been widely used for vascular access in chronic patients for many years, particularly in oncology. It is a reliable device, and when not in use, it requires relatively low maintenance care. However, as indicated by the recent study by...
Haemodynamic 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...
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,...
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...